Stereotactic radiosurgery for acoustic neuromas: A survey of the American Neurotology Society

Objective: The pur pose of this study was to better understand the complications, outcomes, and surgical difficulties in treat in:: acoustic neuroma patients who have undergone stereotactic radiosurgery (SRS). Study Design: A six-page, 28-item questionnaire was mailed to 395 members of the American Neurotology Society. Setting: The study was conducted through an academic neurotologic practice. Questionnaire respondents were neurotologic physicians in private and academic practice. Patients: A total of 36 patients who had undergone SRS were evaluated. Interventions: Twelve (26%) of the 46 patients required microsurgery after SRS. Main Outcome Measures: Posttreatment cranial nerve status and the development of complications such as cerebrospinal fluid leak;, meningitis, and cerebrovascular accident were evaluated. Results: In the group of 12 patients who underwent microsurgery after SRS, 11 patients had some form of postoperative facial paralysis. Anacusis was present in all 12 patients. Two of the 12 patients had new-onset trigeminal neuropathy postoperatively. Conclusion: Microsurgical resection of acoustic neuroma after SRS is technically difficult. The difficulty exists regardless of the time of microsurgical resection after SRS. Patients who underwent microsurgery after SRS had uniformly poor cranial nerve results.