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Management of non-vestibular schwannomas in adult patients: a systematic review and consensus statement on behalf of the EANS skull base section Part III: Lower cranial nerve schwannomas, jugular foramen (CN IX, X, XI) and hypoglossal schwannoma (XII)

Journal

ACTA NEUROCHIRURGICA
Volume 164, Issue 2, Pages 321-329

Publisher

SPRINGER WIEN
DOI: 10.1007/s00701-021-05072-y

Keywords

Non-vestibular schwannoma; Radiosurgery; Jugular foramen schwannoma; Hypoglossal nerve schwannoma; Lower cranial nerve schwannoma; Quality of life

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This article discusses the surgical management and strategies for non-vestibular schwannomas, aiming to provide recommendations for the treatment of these tumors. The research team conducted an extensive systematic review, discussing preoperative radiological investigations, ophthalmological assessments, surgical and radiotherapy strategies, and follow-up management.
Background Non-vestibular schwannomas are relatively rare, with trigeminal and jugular foramen schwannomas being the most common. This is a heterogenous group which requires detailed investigation and careful consideration to management strategy. The optimal management for these tumours remains unclear, and there are several controversies. The aim of this paper is to provide insight into the main principles defining management and surgical strategy, in order to formulate a series of recommendations. Methods A task force was created by the EANS skull base section committee along with its members and other renowned experts in the field to generate recommendations for the surgical management of these tumours on a European perspective. To achieve this, the task force performed an extensive systematic review in this field and had discussions within the group. This article is the third of a three-part series describing non-vestibular schwannomas (IX, X, XI, XII). Results A summary of literature evidence was proposed after discussion within the EANS skull base section. The constituted task force dealt with the practice patterns that exist with respect to preoperative radiological investigations, ophthalmological assessments, optimal surgical and radiotherapy strategies and follow-up management. Conclusion This article represents the consensually derived opinion of the task force with respect to the treatment of non-vestibular schwannomas. For each of these tumours, the management paradigm is shifting towards the compromise between function preservation and progression free survival.

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