Vestibular schwannomas are the most common tumors of the cerebellopontine angle (CPA), the junction between the cerebellum and the brainstem. They constitute around 8% of intracranial tumors. They are benign and arise from the vestibular nerve within the internal auditory canal growing from the canal into the CPA eventually causing brainstem compression. Their incidence is around 2.5 per 100,000. Around 70% of tumors do not grow following diagnosis but those that do or those that are already large at presentation are usually treated either with stereotactic radiosurgery or microsurgical resection.
Vestibular schwannomas have been extensively investigated over the years with nearly 10,000 peer reviewed papers relating to them on Pubmed. Despite this plethora of data there are very few books that assimilate the literature to provide a comprehensive, readable and contemporary overview of their management. This book aims to meet these requirements covering both sporadic and neurofibromatosis type 2 vestibular schwannomas.
The chapters within the book will cover all aspects of the diagnosis and management of vestibular schwannomas. Opening chapters provide a historical back drop, followed by current state of the art of molecular biology, histopathology and genomics relating to vestibular schwannomas. A comprehensive section related to the assessment of patients with vestibular schwannomas will highlight the multidisciplinary approach to the management of these tumors. This will set out some of the cutting edge research currently being undertaken in prediction of tumor growth using novel biological and radiological markers. The next section focuses on the treatment of vestibular schwannomas. This will make up the largest proportion of the book and will cover all treatment modalities from observation through to stereotactic radiosurgery and microsurgical resection. Lastly will be a section focusing on rehabilitation of neurological deficit arising as a result of the disease or its treatment.
Table of Contents
Introduction1. History of? VS management
Basic Science
2, Anatomy and histopathology of vestibular schwannomas
3. Molecular biology and disease models of vestibular schwannomas: State of the art
4. Vestibular schwannoma micro-environment
5. Genomics of vestibular schwannoma
Assessment
6. Clinical evaluation of patients with a VS
7. Radiology and Differential diagnosis of cerebellopontine angle tumours
8. The MDT approach to managing VS
9. Natural history and epidemiology of vestibular schwannomas
Treatment
10. Watch wait and rescan for vestibular schwannomas
11. Medical therapy for vestibular schwannomas
12. Translab approach to vestibular schwannomas
13. Retrosigmoid approach to vestibular schwannomas
14. Middle fossa approach to vestibular schwannomas
15. Outcomes of rescue surgery following failed primary treatment
16. Vestibular Schwannoma Microsurgical Technique
17. Outcomes following VS surgery
18. Hearing preservation surgery
19. How to deal with complications following VS surgery
20. Neuroanaesthesia and peri-operative care of vestibular schwannoma surgery
Stereotactic radiosurgery for vestibular schwannomas
21. Radiobiology of radiotherapy treatments in? vestibular schwannoma
22. Radiotherapy modalities in vestibular schwannoma treatment
23. Outcomes and complications of radiotherapy in vestibular schwannomas
General Considerations
24. Decision making in sporadic VS
25. Decision making in NF2
26. Quality of life after treatment of vestibular schwannomas
27. The role of the specialist nurse in skull base disease
28. Managing vestibular schwannoma in the developing world
Rehabilitation
29. Managing trigeminal neuralgia in VS
30. Hearing rehab in patients with a VS
31. Rehabilitation of facial palsy in patients with vestibular schwannoma
32. Managing dizziness in patients with vestibular schwannomas
33. Managing tinnitus in patients with vestibular scwhannomas
