Radiosurgery for facial schwannoma

Object. The aim of this study was to evaluate the results of radiosurgery in patients with facial schwannoma. Methods. The study population consisted of 14 patients, six men and eight women, with a mean age of 45.4 years. Most of the patients had presented with facial palsy (11 of 14 patients) and/or hearing disturbance (nine of 14 patients). Prior treatment in nine of the 14 cases consisted of tumor resection or tumor biopsy. Tumor volume ranged from 0.98 to 20.8 cm(3), and the mean tumor volume was 5.5 cm(3). The mean maximum radiation dose and mean tumor margin dose used for radiosurgery were 24.0 and 12.9 Gy, respectively. During the mean follow-up period of 31.4 months (range 12-120 months), 10 of the tumors shrank and four remained unchanged. The tumor response and tumor control rates were 57 and 100%, respectively. None of the tumors progressed, and no subsequent resection was required. Facial nerve function improved in five cases, remained unchanged in eight, and became worse in one. There was no change in hearing function in any of the patients. Complications developed in only one patient: the onset of facial palsy immediately after treatment, which subsequently recovered to House-Brackmann Grade III. Conclusions. In summary, radiosurgery was found to be a very useful method of treating facial schwannoma, for both tumor control and functional control. Radiosurgery should therefore be the treatment of first choice for facial schwannomas.