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Scientific Oral Presentation

Otology/Neurotology

Comparative Analysis of Surgical Outcomes in Patients with Acoustic Neuroma: Microsurgery versus Stereotactic Radiosurgery

Saturday, October 17, 2026
3:00 PM - 3:06 PM PT
Location: 515B

    Presenting Author(s)

  • Robert E. Africa, MD

    Resident
    The University of Texas Medical Branch
    Galveston, TX, United States

    • Co-Author(s)

  • Shahrukh R. ali, MD

    Shahrukh Ali
    University of Texas Medical Branch
    Richmond, TX, United States

  • DY

    Dayton L. Young, MD

    Associate Professor and Director of Quality and Value, Department of Otolaryngology
    University of Texas Medical Branch
    Galveston, Texas, United States

    • Senior Author(s)

  • Brian J. McKinnon, MD, MBA, MPH

    Chair of Surgery
    Meritus Health
    Hagerstown, Maryland, United States

Disclosure(s):
Brian J. McKinnon, MD, MBA, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Compared with microsurgery (MS), stereotactic radiosurgery (SRS) has been associated with less morbidity but comparatively reduced tumor control. Large, multicenter database studies are needed to evaluate and compare outcomes, risks, and complications between these two major procedures, which may help inform treatment decisions.

Methods: This is a retrospective cohort study utilizing de-identified patient data from 49 healthcare institutions in the United States from the TriNetX database. Data were collected from January 1, 2010 to December 31, 2023. All patients were adults aged 18 years or older with a history of acoustic neuroma and prior intervention with either microsurgery or stereotactic radiosurgery. Propensity score matching was used to control for demographics and socioeconomic factors. Evaluated outcomes included functional status, debilitation, dysarthria, dysphagia, need for facial nerve reanimation, requirement for physical therapy/occupational therapy, tinnitus, and reintervention with the alternate treatment modality. Outcomes were assessed at 6 months, 1 year, 3 years, 5 years, and 10 years following treatment and were reported as relative risks (RRs) with 95% confidence intervals (95% CI).

Results: Primary MS was associated with a higher rate of functional impairments at 6 months including dysphagia (RR: 3.40[1.71-6.78]), facial nerve reanimation (RR: 2.70[1.33-5.50]), and the need for physical therapy/occupational therapy (RR: 13.50[7.27-25.07]). Rates of tinnitus following MS were higher through 1 year (RR: 1.30[1.03-1.65]), but were comparable to SRS by 3 years (RR: 1.18[0.96-1.45]). MS after initial SRS was significant at 5 years (RR: 0.05[0.003-0.81]). Radiation after initial MS was significant after 10 years (RR: 2.70[1.33-5.50]). Rates of dysarthria did not differ significantly between groups (RR: 1.10[0.47-2.56]).

Conclusions: MS was associated with higher rates of functional outcomes and debilitation than SRS. The rate of re-intervention with MS after initial SRS was earlier than radiation after microsurgery.