ABSTRACT
A retrospective analysis of 162 consecutive cases in 160 patients who underwent microsurgical
resection of vestibular schwannomas between October 1995 and June 2001 was undertaken
to compare the results with those of other treatment modalities. Patient hospital
records, operative video pictures, neuroimaging studies, audiograms, and follow-up
data were reviewed. The mean follow-up period was 24 months.
There were 34 small (<1.5 cm), 92 medium (1.5-3 cm), and 36 (>3 cm) large tumors.
Six were recurrent tumors. Gross total resection was accomplished in all 34 small
tumors and 92 medium tumors but only in 50% of the large tumors. Among the 126 small
and medium tumors, the facial nerve was saved anatomically in 124 patients. On long-term
follow up, facial function was preserved in 94.4% of all patients. Anatomically, the
cochlear nerve was preserved in 55.9% of the small and 20.7% of the medium tumors.
Function was preserved (Gardner-Robertson class 1 and 2) in 25% of the small and in
19.4% of the medium tumors. Cerebrospinal leakage was present in 10.5%, meningitis
in 9.9%, wound infection in 3.7%, and hematoma or contusion in 2.5%. Only one patient
died (mortality rate 0.6%). Our data reflect that surgical removal should be the standard
management for acoustic tumors, particularly for large and medium tumors, and can
be accomplished with acceptable complication rates.
KEYWORDS
Acoustic neuroma - complications - surgical outcome
