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Cohort studyJournal of neuro-oncology · 2026

Comparative analysis of stereotactic radiosurgery and microsurgery for vestibular schwannoma: a clinical and radiological evaluation.

Andre E Boyke, Tariq Al-Saadi, Simon A Menaker … John S Yu

SurgeryCohort study

Microsurgery was associated with a significant reduction in vestibular schwannoma tumor size.

Comparative analysis of stereotactic radiosurgery and microsurgery for vestibular schwannoma: a clinical and radiological evaluation.

Andre E Boyke et al. · Journal of neuro-oncology · 2026

Purpose

To compare radiographic and clinical outcomes of vestibular schwannoma management using stereotactic radiosurgery (SRS) and microsurgical resection, with emphasis on paired pre- and post-treatment changes in tumor size and patient outcomes.

Methods

A retrospective review was conducted of 87 patients treated for vestibular schwannoma between 2013 and 2024 at a single tertiary center.

n = 87 patients

Results

the median reduction in tumor area after microsurgery

n = 87 patients

More results

Koos grade correlated with both brainstem compression and hearing loss, with higher grades favoring surgical management (p = 0.049).

In the Koos IV subset, surgery achieved significant tumor reduction without disproportionate postoperative deficits compared with lower grades.

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Conclusion · 1 of 2

Microsurgery provides immediate and substantial tumor reduction without increased morbidity, while SRS maintains radiographic stability with favorable clinical outcomes.

Conclusion · 2 of 2

These findings underscore the complementary roles of both modalities and support the Koos classification as a practical and reliable framework for treatment selection.

Post

Comparative analysis of stereotactic radiosurgery and microsurgery for vestibular schwannoma: a clinical and radiological evaluation.

Microsurgery was associated with a significant reduction in vestibular schwannoma tumor size.

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