Commentary “Treatment of Large and Giant Residual and Recurrent Vestibular Schwannomas”

The authors present a series of 15 patients with previously subtotally resected recurrent or residual vestibular schwannomas. Their surgical results were quite good and were associated with relatively few complications. The facial function of 5 patients deteriorated. Gross total resection was achieved in all patients. Unsurprisingly, the arachnoid plane was indistinct, and the facial nerve was difficult to identify. The most important take-home message, however, is that the initial surgery is the best time to achieve gross total resection while minimizing the risk of complications.