Abstract：
OBJECTIVE: The incidence and risk factors for facial nerve dysfunction (FND) following CyberKnife® therapy for vestibular schwannoma (VS) remain poorly understood. This study investigates whether differential radiation doses to vulnerable segments of the facial nerve may be associated with FND outcomes.
METHODS: Patients were identified who underwent CyberKnife® radiosurgery for VS at a single institution. Basic demographics, tumor characteristics, and facial nerve function were collected. Total radiation doses to tumor, internal auditory canal (IAC), and labyrinthine segment of facial nerve (LSFN) were evaluated.
RESULTS: Six out of 64 patients experienced FND following CyberKnife® treatment for VS (9.38%, 6/64). Patients with FND were compared to those without FND (control). Of the 64 patients, complete radiation records were obtained for 30 patients (6 FND vs. 24 control). There were no significant differences in demographic or tumor characteristics between control and FND cohorts. More severe FND (HB ≥ 4) had significantly larger tumors (3.74 vs. 1.27 cm3, p = 0.037) with directionally decreased time to FND (3.50 vs. 33.5 months, p = 0.106) than patients with HB < 4, respectively. There were directionally, nonsignificant differences between maximum radiation doses to the LSFN (2492.4 vs. 2557.0 cGy, p = 0.121) and IAC (2877.3 vs. 2895.5 cGy, p = 0.824) between the control and FND cohorts, respectively.
CONCLUSIONS: FND may represent an underrecognized sequelae of CyberKnife® radiosurgery for VS that can occur many months following treatment. Further studies are needed to elucidate the effect of differential radiation exposure to the facial nerve with FND following treatment.
METHODS: III (Retrospective Cohort Study) Laryngoscope, 2024.
METHODS: Patients were identified who underwent CyberKnife® radiosurgery for VS at a single institution. Basic demographics, tumor characteristics, and facial nerve function were collected. Total radiation doses to tumor, internal auditory canal (IAC), and labyrinthine segment of facial nerve (LSFN) were evaluated.
RESULTS: Six out of 64 patients experienced FND following CyberKnife® treatment for VS (9.38%, 6/64). Patients with FND were compared to those without FND (control). Of the 64 patients, complete radiation records were obtained for 30 patients (6 FND vs. 24 control). There were no significant differences in demographic or tumor characteristics between control and FND cohorts. More severe FND (HB ≥ 4) had significantly larger tumors (3.74 vs. 1.27 cm3, p = 0.037) with directionally decreased time to FND (3.50 vs. 33.5 months, p = 0.106) than patients with HB < 4, respectively. There were directionally, nonsignificant differences between maximum radiation doses to the LSFN (2492.4 vs. 2557.0 cGy, p = 0.121) and IAC (2877.3 vs. 2895.5 cGy, p = 0.824) between the control and FND cohorts, respectively.
CONCLUSIONS: FND may represent an underrecognized sequelae of CyberKnife® radiosurgery for VS that can occur many months following treatment. Further studies are needed to elucidate the effect of differential radiation exposure to the facial nerve with FND following treatment.
METHODS: III (Retrospective Cohort Study) Laryngoscope, 2024.
摘要：
目的：CyberKnife®治疗前庭神经鞘瘤（VS）后面神经功能障碍（FND）的发生率和危险因素仍然知之甚少。这项研究调查了对面神经脆弱段的不同辐射剂量是否可能与FND结果相关。
方法：确定在单一机构接受CyberKnife®放射外科治疗的患者。基本人口统计学,肿瘤特征，收集面神经功能。对肿瘤的总辐射剂量，内听道（IAC），评估面神经迷宫段（LSFN）。
结果：64例患者中有6例在Cyberknife®VS治疗后经历了FND（9.38％，6/64)。将患有FND的患者与没有FND的患者(对照)进行比较。64名患者中,获得了30例患者的完整放射记录(6例FND与24控制）。对照组和FND队列之间的人口统计学或肿瘤特征没有显着差异。更严重的FND（HB≥4）有明显更大的肿瘤（3.74vs.1.27cm3，p=0.037），方向减少时间至FND（3.50vs.33.5个月，p=0.106）分别高于HB<4的患者。有方向，对LSFN的最大辐射剂量之间的差异不显著(2492.4与2557.0cGy,p=0.121）和IAC（2877.3vs.2895.5cGy,p=0.824）在对照和FND队列之间，分别。
结论：FND可能代表了CyberKnife®放射外科治疗VS的未被认可的后遗症，可在治疗后数月发生。需要进一步的研究来阐明FND治疗后对面神经的不同辐射暴露的影响。
方法：III（回顾性队列研究）喉镜，2024.
方法：确定在单一机构接受CyberKnife®放射外科治疗的患者。基本人口统计学,肿瘤特征，收集面神经功能。对肿瘤的总辐射剂量，内听道（IAC），评估面神经迷宫段（LSFN）。
结果：64例患者中有6例在Cyberknife®VS治疗后经历了FND（9.38％，6/64)。将患有FND的患者与没有FND的患者(对照)进行比较。64名患者中,获得了30例患者的完整放射记录(6例FND与24控制）。对照组和FND队列之间的人口统计学或肿瘤特征没有显着差异。更严重的FND（HB≥4）有明显更大的肿瘤（3.74vs.1.27cm3，p=0.037），方向减少时间至FND（3.50vs.33.5个月，p=0.106）分别高于HB<4的患者。有方向，对LSFN的最大辐射剂量之间的差异不显著(2492.4与2557.0cGy,p=0.121）和IAC（2877.3vs.2895.5cGy,p=0.824）在对照和FND队列之间，分别。
结论：FND可能代表了CyberKnife®放射外科治疗VS的未被认可的后遗症，可在治疗后数月发生。需要进一步的研究来阐明FND治疗后对面神经的不同辐射暴露的影响。
方法：III（回顾性队列研究）喉镜，2024.
