Abstract：
This letter evaluates the recent study on the management of cystic vestibular schwannomas (VS) compared to solid VS, focusing on the clinical outcomes of surgery (SURGERY) and radiosurgery (SRS). The study offers significant insights into the differences between these tumor types, emphasizing the challenges posed by cystic VS, including rapid growth, enhanced peritumoral adhesion, and worse post-operative facial nerve outcomes. Notably, cystic VS are associated with higher recurrence rates and poorer preoperative status. The study also highlights lower gross total resection (GTR) rates and poorer long-term tumor control in cystic VS. While SRS shows high rates of functional preservation, it is less effective in ensuring recurrence-free survival in cystic VS compared to solid VS, suggesting surgery may be preferable for achieving the best long-term outcomes, particularly when safe maximal resection is possible. However, the study\'s retrospective design and limited sample size, along with the lack of standardized follow-up protocols, may impact the generalizability of the findings. Future research should focus on prospective, multicenter studies with standardized protocols to develop evidence-based guidelines for managing cystic VS. Innovative techniques, such as advanced imaging and minimally invasive surgical approaches, may further improve diagnostic accuracy and treatment efficacy. This study underscores the complexities of managing cystic VS and the need for tailored treatment strategies.
摘要：
这封信评估了最近关于囊性前庭神经鞘瘤（VS）与固体VS相比的治疗研究，重点关注手术（SURGERY）和放射外科（SRS）的临床结果。该研究为这些肿瘤类型之间的差异提供了重要的见解，强调囊性VS带来的挑战，包括快速增长，增强肿瘤周围粘连，术后面神经结局更差。值得注意的是,囊性VS与较高的复发率和较差的术前状态相关。该研究还强调了囊性VS的总切除率（GTR）较低，长期肿瘤控制较差。虽然SRS显示出很高的功能保存率，与固体VS相比，它在确保囊性VS的无复发生存率方面效果较差，建议手术可能更适合获得最佳的长期结果，特别是当安全最大切除是可能的。然而,研究的回顾性设计和有限的样本量，随着缺乏标准化的后续协议，可能会影响调查结果的普遍性。未来的研究应该集中在前瞻性，具有标准化方案的多中心研究，以制定基于证据的治疗囊性VS的指南。创新技术,如先进的成像和微创手术方法，可进一步提高诊断准确性和治疗效果。这项研究强调了管理囊性VS的复杂性以及对定制治疗策略的需求。
