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Open Access 01-01-2020 | Vestibular Schwannoma | Original Article - Tumor - Schwannoma

Facial nerve function and hearing after microsurgical removal of sporadic vestibular schwannomas in a population-based cohort

Authors: Ismail Taha, Antti Hyvärinen, Antti Ranta, Olli-Pekka Kämäräinen, Jukka Huttunen, Esa Mervaala, Heikki Löppönen, Tuomas Rauramaa, Antti Ronkainen, Juha E. Jääskeläinen, Arto Immonen, Nils Danner

Published in: Acta Neurochirurgica | Issue 1/2020

Abstract

Background

Vestibular schwannoma (VS) is a benign tumor originating from the vestibulocochlear nerve. The optimal treatment strategy is debated, since surgery may result in iatrogenic facial nerve injury. We report the results of VS surgery in a population-based unselected cohort in a center with access to Cyber Knife (CK) radiosurgery.

Methods

We reviewed 117 consecutive operations and found 95 patients who had their primary operation due to vestibular schwannoma between 2001 and 2017. Facial nerve function was evaluated with the House-Brackmann (HB) scale and hearing with the EU classification.

Results

The population consisted of 37 males and 58 females with a median age of 54 years (range 19–79). One year after surgery 67% of patients had a good outcome (HB 1–2). The rate of good outcome was 90% if no facial nerve damage was observed during intraoperative monitoring, the size of the tumor was under 30 mm and no hydrocephalus was present. During the study period, the treatment strategy changed from total to near-total resection after the introduction of CK radiosurgery, which could be used as a second-line treatment in case of residual tumor regrowth. This resulted in an improvement of outcomes (0% HB 5–6) despite the larger tumor sizes (25 ± 14 mm vs. 31 ± 9 mm, p < 0.05). Hearing preservation rates did not increase.

Conclusions

Near-total resection and subsequent CK radiosurgery in case of residual tumor regrowth during follow-up seems to provide a good outcome of facial nerve function even in large VSs.

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Title: Facial nerve function and hearing after microsurgical removal of sporadic vestibular schwannomas in a population-based cohort
Authors: Ismail Taha
Antti Hyvärinen
Antti Ranta
Olli-Pekka Kämäräinen
Jukka Huttunen
Esa Mervaala
Heikki Löppönen
Tuomas Rauramaa
Antti Ronkainen
Juha E. Jääskeläinen
Arto Immonen
Nils Danner
Publication date: 01-01-2020
Publisher: Springer Vienna
Keywords: Vestibular Schwannoma
Vestibular Schwannoma
Published in: Acta Neurochirurgica / Issue 1/2020
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-019-04055-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Facial nerve function and hearing after microsurgical removal of sporadic vestibular schwannomas in a population-based cohort

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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