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Koos Classification (Vestibular Schwannoma)

1.0.0

Assigns Koos grade I–IV for vestibular schwannoma based on intracanalicular versus cisternal extent and contact or compression of the brainstem, aiding surgical and radiosurgical planning.

Also searched as: acoustic neuroma · CPA · skull base · MRI · cerebellopontine angle · brain · ear

Koos grade

Base on high-resolution contrast-enhanced MRI (cisternal and IAC sequences).

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How this tool works

The Koos classification (popularized from 1990s microsurgical series) stages vestibular schwannomas by extrameatal growth and mass effect on the brainstem rather than by linear diameter alone. Grade I is purely intracanalicular; II extends into the CPA cistern without brainstem contact; III fills the cistern and contacts brainstem without displacement; IV compresses/displaces brainstem and cranial nerves. Higher grades correlate with greater surgical complexity and facial-nerve risk; grade also influences candidacy for observation, SRS, or microsurgery.

References

Implemented from the cited published sources. Educational use only; confirm against current guidelines before clinical use.

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