Outcome Analysis Of Small To Medium Sized Acoustic Neuroma Treated By Microsurgery Or Gamma Knife Stereotactic Radiosurgery

Objective To discuss the the best management for patients with small to medium sized acoustic neuroma by analyzing the outcome of small to medium sized acoustic neuroma treated by microsurgery or gamma knife stereotactic radiosurgery.Methods We analyzed the treatment outcomes of 87 patients with unilateral acoustic neuroma less than 3cm retrospectively.The patients were divided into two groups:Gamma Knife Stereotactic Radiosurgery group(GRS group,n=42) and Microsurgery group(MS group,n=45).Then we campared these two treatment modalities with tumor growth control rate,cranial nerve function preservation rate,complications,management charges and hospital stay.Results The MS group was followed up 2-67 months,averaged 31.5 months,and the GRS group was followed up 3-77 months,averaged 37.3 months.The tumor growth control rate of GRS group and MS group was 88.1% and 97.8% separately, the difference was not statistically significant (P =0.102);The facial nerve function preservation rate of GRS group and MS group was 87.2% and 66.7% separately, the difference was statistically significant;The useful hearing preservation rates of GRS group and MS group was 68.2% and 30.0% separately, the difference was statistically significant (P =0.013);The trigeminal nerve function preservation rate of GRS group and MS group was 97.6% and 95.6% separately, the difference was not statistically significant(P =1.000);Either the type or frequency of postoperative complications in MS group was higher than GRS group;The total management charge and hospital stay of MS group was significantly higher than GRS group. Conclusion Gamma knife stereotactic surgery can control the growth of acoustic neuroma and protect the cranial nerve function effectively,and has fewer postoperative complications, less management charges and shorter hospitalization period. So it has more advantages than microsurgery in the treatment of small to medium sized acoustic neuroma. The major restriction of its clinical application is its slow onset.