gms | German Medical Science

Objective: In a consecutive series operated at a single institution, the results of surgery performed by neurosurgical (NCH) teams were compared with those performed by a NCH-ENT teams retrospectively. To compare the results of vestibular schwannomas resection performed by NCH teams with those performed by interdisciplinary neurosurgical-otolaryngology (NCH-ENT) teams.

Method: The following parameters were considered for comparison: duration of surgery, morphological preservation of the VII. cranial nerve (CN), function of the VII. CN House and Brackmann scale (H&B), preservation of useful hearing, overall complications, discharge home and Karnofsky Performance Index (KPI).

Results: Out of 194 patients, 152 patients were operated by NCH teams and 42 patients by NCH-ENT teams, all by a retrosigmoidal approach. The two patient groups did not significant differ by gender, age, ASA score, preoperative function of the VII and VIII CN and tumor size. The patients were followed-up postoperatively for a median of 19 months (Range 3 to 370 months). The duration of surgery tended to be somewhat shorter when performed by the NCH teams as compared to NCH-ENT-teams (NCH mean 331 min vs NCH-ENT mean 369 min p=0,066). Intraoperatively, the VII. CN was considered to be morphologically preserved less frequently when surgery was done by NCH, as compared to NCH-ENT teams (NCH 78,4% vs. NCH-ENT 95,2%, p=0,039). However, the postoperative function of the VII. CN, as assessed by the H&B scale, did not differ according to the surgical teams, neither early postoperative (NCH median score 3 vs. NCH-ENT median score 3, p=0,678), nor at last follow-up (NCH median score 2 vs. NCH-ENT median score 2, p≤1). No statistically significant differences were found between the two treatment groups regarding overall complication rates (NCH 20,0% vs. NCH-ENT 29,0% p=0,289), perioperative mortality (NCH 3,2% vs. NCH-ENT, 2,4%, p≤1,000), rate of dischargement home (NCH 69,0% vs. NCH-ENT 69,0%, p≤1,000), rate of preserved hearing at discharge (NCH 2,0% vs. NCH-ENT 0,0%) and at last follow-up (NCH 2,0% vs. NCH-ENT 0,0%), of the KPI at discharge (NCH mean 85 vs. NCH-ENT mean 84 p≤1,000) and at last follow-up (NCH mean 89,5 vs. NCH-ENT 90,0, p≤1,000).

Conclusions: In this retrospective study, there were found no clinical relevant differences in the postop outcome of patients with vestibular schwannomas operated by NCH team compared to interdisciplinary NCH-ENT teams. However these results have to be confirmed in a prospective randomized study.