Functional Outcome and Complications After the Microsurgical Removal of Giant Vestibular Schwannomas Via the Retrosigmoid Approach: a Retrospective Review of 16-year Experience in a Single Hospital

Overview

Journal BMC Neurol

Publisher Biomed Central

Specialty Neurology

Date 2017 Feb 1

PMID 28137246

Citations 21

Authors

Xiang Huang

Jian Xu

Ming Xu

Mingyu Chen

Kaiyuan Ji

Junwei Ren

Ping Zhong

Affiliations

Soon will be listed here.

Abstract

Background: Intracranial vestibular schwannoma still remain to be difficulty for its unique microsurgical technique and preservation of neuro-function, as well as reducing common complications that may arise in surgery.

Methods: We consecutively enrolled 657 unilateral giant (>4 cm diameter) vestibular schwannoma patients treated in Huashan Hospital via the suboccipital retrosigmoid approach in the past 16 years. The extension of tumor removal, surgical mortality, facial nerve function, hearing, and the other main short and long-term complications were the studied parameters.

Results: Gross total resection was performed in 556 patients (84.6%); near-total resection was achieved in 99 patients (15.1%). The mortality rate is 0.6%. The main short-term complications included 'new' deafness (47.6%), intracranial infection (7.6%), lower cranial nerve defects (7.5%) and pneumonia (6.2%). The facial nerve was preserved anatomically in 589 cases (89.7%). Good facial nerve functional outcome (House-Brackmann Grades I and II) postoperatively was achieved in 216 patients (32.9%). Other 308 cases (46.9%) were House-Brackmann grade III, and 133 patients (20.2%) were House-Brackmann grade IV-VI. Follow-up data were available for 566 of the 657 patients (86.1%). The common long-term complications were hearing loss (85.2%), facial paralysis (HB grade IV-VI, 24.4%) and facial numbness (15.7%).

Conclusions: Trends in the data lead the authors to suggest that the microsurgical technique, intraoperative nerve monitoring, and multidisciplinary cooperation, were the keys to improving prognostic outcomes in giant intracranial vestibular schwannoma patients.

Citing Articles

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Functional outcomes after retrosigmoid approach to the cerebellopontine angle: Observations from a single-center experience of over 13 years.

Aftahy A, Goldberg M, Butenschoen V, Wagner A, Meyer B, Negwer C Brain Spine. 2024; 4:102909.

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Prevalence and patterns of cerebral venous sinus thrombosis following vestibular schwannoma surgery: a systematic review and meta-analysis.

Mirdamadi A, Javid M, Nemati S, Keivanlou M, Javid M, Amini-Salehi E Eur Arch Otorhinolaryngol. 2024; 281(8):3879-3891.

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Premorbid Psychological Factors Associated with Long-Term Postoperative Headache after Microsurgery in Vestibular Schwannoma-A Retrospective Pilot Study.

Thomas M, Rampp S, Scheer M, Strauss C, Prell J, Schonfeld R Brain Sci. 2023; 13(8).

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Clinical outcomes and safety of large or giant vestibular schwannoma in older patients undergoing microsurgery: a matched cohort study.

Wu Y, Cai Q, Zheng M, Li J, Xue Y, Qu Y J Neurooncol. 2023; 163(2):429-437.

PMID: 37222918 DOI: 10.1007/s11060-023-04330-6.

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