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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 I: oculomotor and other rare non-vestibular schwannomas (I, II, III, IV, VI)

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ACTA NEUROCHIRURGICA
卷 164, 期 2, 页码 285-297

出版社

SPRINGER WIEN
DOI: 10.1007/s00701-021-05048-y

关键词

Non-vestibular schwannoma; Radiosurgery; Olfactory schwannoma; Oculomotor schwannoma; Trochlear schwannoma; Abducens schwannoma; Quality of life

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Non-vestibular schwannomas, including trigeminal and jugular foramen schwannomas, are relatively rare and require detailed investigation for management. This article provides insight into the main principles defining management and surgical strategy, aiming to formulate recommendations for these tumors.
Background Non-vestibular schwannomas are relatively rare, with trigeminal and jugular foramen schwannomas being the most common. This is a heterogeneous 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 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 first of a three-part series describing non-vestibular schwannomas (I, II, III, IV, VI). 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 pre-operative 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 of these patients is complex, and for those which are symptomatic tumours, the paradigm is shifting towards the compromise between function preservation and progression-free survival.

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