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Acta Neurochirurgica
Published in: Acta Neurochirurgica 7/2017

01-07-2017 | How I Do it - Neurosurgical Techniques

Facial nerve sparing surgery for large vestibular schwannomas

Authors: Paolo Ferroli, Lorenzo Bosio, Morgan Broggi

Published in: Acta Neurochirurgica | Issue 7/2017

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Abstract

Background

Nowadays, there is a general trend in vestibular schwannoma (VS) surgery favoring near-total or subtotal tumor resection (NTR/STR) with facial nerve (FN) function preservation rather than gross total resection (GTR) with high risk of FN damage.

Methods

The surgical technique of FN sparing in large VS includes patient-tailored image-guided craniotomy, continuous intraoperative neurophysiological monitoring (INM), intracapsular wide tumor debulking, and only final extracapsular dissection with FN course identification and brainstem decompression. A small amount of residual tumor along the FN is accepted in order to not damage the nerve. Postoperative radiosurgery workup is then recommended.

Conclusions

NTR/STR resection with FN function sparing is a valid option for large VS.
Appendix
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Metadata
Title
Facial nerve sparing surgery for large vestibular schwannomas
Authors
Paolo Ferroli
Lorenzo Bosio
Morgan Broggi
Publication date
01-07-2017
Publisher
Springer Vienna
Published in
Acta Neurochirurgica / Issue 7/2017
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI
https://doi.org/10.1007/s00701-017-3216-y

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