Surgical Treatment of Vestibular Schwannoma. Review of 420 Cases

Abstract Introduction and objectives Vestibular schwannoma is the most frequent cerebellopontine angle tumour. The aim of our study is to reflect our experience in the surgical treatment of this tumour. Material and methods Retrospective study of 420 vestibular schwannomas operated in our hospital between 1994 and 2014. We include tumour size, preoperative hearing, surgical approaches, definitive facial and hearing functional results, and complications due to surgery. Results A total of 417 patients with 420 tumours were analysed, 209 female (50.1%) and 208 male (49.9%). Mean age at diagnosis was 49.8±13.2 years. The majority of the tumours were resected through a translabyrinthine approach (80.2%). Total tumour removal was achieved in 411 tumours (98.3%), and anatomic preservation of facial nerve in 404 (96.2%). Definitive facial nerve outcome was House–Brackmann grade I and II in 69.9%, and was significantly better in tumours under 20 mm. Surgical complications included cerebrospinal fluid leakage in 3 patients (0.7%) and retroauricular subcutaneous collection in 16 (3.8%), 5 cases of meningitis (1.2%), 4 patients with intracraneal bleeding (0.9%), and death in 3 patients (0.7%). Conclusions Surgery is the treatment of choice for vestibular schwannoma in the majority of patients. In our experience, the complication rate is very low and tumour size is the main factor influencing postoperative facial nerve function.