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Original Articles
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Long-Term Results of CyberKnife Radiosurgery for Vestibular Schwannoma
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Ho Joong Lee, Chae Dong Yim, Hyun Woo Park, Dong Gu Hur, Ho Jin Jeong, Seong-Ki Ahn
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Res Vestib Sci. 2017;16(1):23-28. Published online March 15, 2017
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DOI: https://doi.org/10.21790/rvs.2017.16.1.23
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Abstract
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- Objective: Since the 2000s, CyberKnife radiosurgery (CKRS) is either a primary or an adjunct management approach used to treat patients with vestibular schwannoma (VS). The goals of CKRS are prevention of tumor growth, preservation of cranial nerve function and prevention of new neurologic deficiencies. The aim of this study was to assess the efficacy and safety of CKRS, in terms of tumor control, hearing preservation, and complications.
Methods
Forty patients with VS underwent CKRS as a treatment modality for from January 2010 to February 2016. The long term results of 32 patients were evaluated who received CKRS as primary treatment. 8 patients presented with previously performed surgical resection. Information related to clinical history, Brain MRI and outcomes of patients with VS collected retrospectively by reviewing patient’s chart and telephone survey.
Results
The mean tumor volume was 3.3 cm3 and the mean follow-up was 41 months. The most recent follow-up showed that tumor size decreased in 17 patients (42.5%), displayed no change in 19 patients (47.5%), and increased in 4 patients (10%). Progression-free survival rates after CKRS at 1, 3, and 5 years were 95%, 90%, and 90%. After CKRS, 13 patients experienced hearing degradation. The overall rate of preservation of serviceable hearing at the long-term follow-up was 60%. Vertigo, ataxia, and headache were improved after CKRS compared with pretreated status. But, facial weakness, trigeminal nerve neuropathy, and tinnitus were worsen.
Conclusion
CKRS provide an excellent tumor control rate and a comparable hearing preservation rate in VS patients. Also CKRS is associated with low rate of cranial neuropathy, other complications.
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Long-Term Follow-Up of Patients with Benign Paroxysmal Positional
Vertigo
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Jin Yong Kim, Joon Seok Ko, Ho Joong Lee, Dong Gu Hur, Seong Ki Ahn
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Res Vestib Sci. 2015;14(3):83-86.
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Abstract
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- Objective: Benign paroxysmal positional vertigo (BPPV) is one of most common
peripheral vestibular disorders. The aim of this study was to identify recurrence
in the long-term follow-up of patients with BPPV after successful canalith
repositioning maneuvers, and to determine which factors contribute to recurrence.
Methods
The authors reviewed the medical records of 202 consecutive patients
with BPPV during the period January 2002 to December 2004 and investigated
112 patients with BPPV treated over the same period. Finally, 71 patients were
enrolled in this study. The estimated risk of recurrence used a Kaplan-Meier
analysis. For long-term follow-up, patients were contacted by telephone for further
information by one experienced doctor.
Results
A total of 71 patients with idiopathic BPPV fulfilled the inclusion criteria.
Forty-two patients had posterior semicircular canal-BPPV and 29 patients
lateral semicircular canal-BPPV. Recurrence rates in the posterior semicircular
canal-and lateral semicircular canal-BPPV were 24% (18/42) and 41% (12/29),
respectively (p>0.05). Recurrence following successful treatment during a longterm
follow-up period was 23 out of 30 patients within 1 year, 5 patients between
1 and 3 years, 1 patient at between 3 and 5 years, 1 patient after 5 years, respectively.
Conclusion
The authors found no significant difference between the posterior
semicircular canal and lateral semicircular canal-BPPV regarding recurrence.
Recurrence mostly occurred within the first 3 years (93%) following successful
canalith repositioning procedure.
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Clinical Characteristics and Natural Course of Benign Paroxysmal Vertigo of Childhood: A Long-Term Follow-Up Study
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Eun Jae Lee, Seong Ki Ahn, Dong Gu Hur, Joon Seok Ko
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Res Vestib Sci. 2013;12(3):93-98.
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Abstract
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- Background and Objectives: It is suggested that some patients with benign paroxysmal vertigo of childhood (BPVC) go on to develop migraine. However, neither the natural course nor the clinical features of BPVC have been determined, and therefore, the aim of this study was to investigate the clinical characteristics and the natural course of BPVC. Materials and Methods: During the period January 2002 to December 2009, we reviewed the clinical records of 58 patients diagnosed with BPVC. All patients were approached by telephone and using a questionnaire. The clinical characteristics of vertigo, such as sex and age distribution, duration and frequency of vertigo, associated symptoms, development of migraine, and neurologic abnormalities, were analyzed. Results: Mean follow- up duration was 73.2 months (range, 31-119 months). Patients had a mean age at onset of 11.8 years and a mean duration of 6.1 years. An obvious female predilection was found, and 40% of BPVC developed to migraine had a family history of migraine. Of the 32 patients, symptoms resolved in 68.7% but were unchanged in five patients (15.6%). BPVC developed to migraine in five patients (15.6%). Conclusion: This study suggests that vertigo spontaneously resolves in the majority of cases. However, the incidence of development to migraine in the BPVC patients is higher than that in general population.