The benefits of vestibular schwannoma treatment by the means of gamma knife radiosurgery. Literature review

Domantas Jakštas1, Gabija Pajedienė1, Monika Martusevičienė2

1Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine

2Lithuanian University of Health Sciences, Kaunas Hospital


Vestibular schwannoma (VS), also known as acoustic neuroma, is a benign, slow-growing tumor that develops due to hyperproduction of Schwan‘s cells surrounding the balance and auditory nerves in the inner ear. Symptoms such as asymmetric hearing loss, tinnitus, dizziness, and imbalance occur as the tumor grows. Significant enlargement of the tumor may exhibit pressure on the surrounding brain structures, leading to various neurological deficits and life-threatening damage to the brain stem. Due to the complex localization of the tumor, surgical treatment is associated with a high risk of complications and more difficult recovery, leading to the increasing use of radiosurgical treatments. Gamma knife stereotaxic radiosurgery is a promising and effective treatment method that is increasingly used to treat VS.

Aim: to collect publications on the treatment of vestibular schwannoma with stereotaxic radiosurgery using Gamma knife and to systematically evaluate the benefits provided by this method over traditional microsurgery.

Methods. A comprehensive search of English-language literature in the PubMed database was performed. The search was performed using MeSH terms: Gamma knife, radiosurgery, stereotactic radiosurgery, vestibular schwannoma, acoustic neuroma.

Article inclusion criteria:

  1. Article was published in English
  2. Article was not older than 15 years
  3. Article was describing the results of vestibular schwannoma treatment by the means of Gamma knife (LINAC radiosurgery and CyberKnife were excluded)

Exclusion criteria:

  1. Articles, describing the use of other radiosurgery modalities, such as LINAC and CyberKnife

Results: with the use of chosen keywords, 60 studies were found. After implementing inclusion and exclusion criteria, 31 articles were selected for further evaluation. After analyzing the information, presented in these articles, we have come to conclusion that Gamma Knife is an effective method of VS treatment, with an advantage as this method can avoid many of the complications associated with open surgical treatment, such as hearing loss, facial or trigeminal nerve dysfunction.

Keywords: vestibular schwannoma, gamma knife, stereotactic radiosurgery.