SynthesisActa neurochirurgica2020
Surgical management for large vestibular schwannomas: a systematic review, meta-analysis, and consensus statement on behalf of the EANS skull base section.
Synthesis in Acta neurochirurgica, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 6 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
42 citing papers in PubMed, 6 syntheses or guidelines pooled it, 102 citations in OpenAlex.
- Facial nerve preservation following gamma knife radiosurgery for vestibular schwannomas in neurofibromatosis type 2: a systematic review and meta-analysis of 552 tumors.Neurosurgical review · 2026Pooled it
- A systematic evaluation of clinical practice guidelines for the treatment and management of vestibular schwannoma.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Pooled it
- The relationship between extent of resection, tumor recurrence, and facial nerve outcomes in vestibular schwannoma surgery: a single-institution experience and systematic review.Journal of neuro-oncology · 2025Pooled it
- Stereotactic radiosurgery for Koos grade IV vestibular schwannoma: a systematic review and meta-analysis.Acta neurochirurgica · 2024Pooled it
- Repeat stereotactic radiosurgery for progressive vestibular schwannomas after previous radiosurgery: a systematic review and meta-analysis.Neurosurgical review · 2021Pooled it
- Current Understanding of Hearing Loss in Sporadic Vestibular Schwannomas: A Systematic Review.Frontiers in oncology · 2021Pooled it
- Morphological Heterogeneity of Large (Koos Grade 4) Vestibular Schwannomas: Surgical Consequences and Predictors of Facial Nerve Outcome.Journal of clinical medicine · 2026Article
- Sporadic sarcoma arising from a previously resected benign vestibular schwannoma without neurofibromatosis or radiosurgery: illustrative case.Journal of neurosurgery. Case lessons · 2026Article
- Radiologic analysis of large vestibular schwannoma position on surgical outcomes.Journal of neuro-oncology · 2026Article
- Pseudoprogression in Koos grade 4 vestibular schwannomas following stereotactic radiosurgery: temporal dynamics and radiological predictors.Journal of neuro-oncology · 2026Article
- Automated Operative Phase and Step Recognition in Vestibular Schwannoma Surgery: Development and Preclinical Evaluation of a Deep Learning Neural Network (IDEAL Stage 0).Neurosurgery · 2026Article
- Advances in imaging modalities and tumor classification for vestibular schwannomas.Journal of neuro-oncology · 2026Review
- Understanding the Translabyrinthine Approach for Neurosurgery Residents: Operative and Educational Video.Journal of neurological surgery reports · 2026Article
- Clinical and inflammatory factors associated with the extent of resection in primary, sporadic vestibular schwannomas: A retrospective study.Acta neuropathologica communications · 2025Article
- Clinician Perspectives of a Magnetic Resonance Imaging-Based 3D Volumetric Analysis Tool for Neurofibromatosis Type 2-Related Schwannomatosis: Qualitative Pilot Study.JMIR human factors · 2025Article
- Management of treatment-naïve Koos grade IV vestibular schwannomas using hypofractionated Gamma Knife radiosurgery: a retrospective single-institution study.Neurosurgical review · 2024Article
- Intraoperative monitoring and early recognition of facial nerve root in vestibular schwannoma surgery.Neurosurgical review · 2024Article
- Planned Subtotal Resection following Stereotactic Radiosurgery of Koos 3 and 4 Vestibular Schwannomas.Journal of clinical medicine · 2024Article
- Single-Center Experience in Microsurgical Resection of Acoustic Neurinomas and the Benefit of Microscope-Based Augmented Reality.Medicina (Kaunas, Lithuania) · 2024Article
- Spontaneous Regression of a Large Vestibular Schwannoma: Is Nonoperative Management Reasonable?Brain tumor research and treatment · 2024Article
Corrections and comments
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Authors and funding
26 authors at 17 institutions in 11 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
objectiveThe optimal management of large vestibular schwannomas continues to be debated. We constituted a task force comprising the members of the EANS skull base committee along with international experts to derive recommendations for the management of this problem from a European perspective. MATERIAL AND
methodsA systematic review of MEDLINE database, in compliance with the PRISMA guidelines, was performed. A subgroup analysis screening all surgical series published within the last 20 years (January 2000 to March 2020) was performed. Weighted summary rates for tumor resection, oncological control, and facial nerve preservation were determined using meta-analysis models. This data along with contemporary practice patterns were discussed within the task force to generate consensual recommendations regarding preoperative evaluations, optimal surgical strategy, and follow-up management.
resultsTumor classification grades should be systematically used in the perioperative management of patients, with large vestibular schwannomas (VS) defined as > 30 mm in the largest extrameatal diameter. Grading scales for pre- and postoperative hearing (AAO-HNS or GR) and facial nerve function (HB) are to be used for reporting functional outcome. There is a lack of consensus to support the superiority of any surgical strategy with respect to extent of resection and use of adjuvant radiosurgery. Intraoperative neuromonitoring needs to be routinely used to preserve neural function. Recommendations for postoperative clinico-radiological evaluations have been elucidated based on the surgical strategy employed.
conclusionThe main goal of management of large vestibular schwannomas should focus on maintaining/improving quality of life (QoL), making every attempt at facial/cochlear nerve functional preservation while ensuring optimal oncological control, thereby allowing to meet patient expectations. Despite the fact that this analysis yielded only a few Class B evidences and mostly expert opinions, it will guide practitioners to manage these patients and form the basis for future clinical trials.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.