gms | German Medical Science

Objective: To describe the clinical outcomes of patients undergoing serial observation or surgical treatment and discuss strategy in managent of vestibular schwannoma.

Methods: In this study, a total of 1700 patients with vestibular schwannoma underwent serial observation or microsurgery. 1575 patients underwent surgical removal from 2001 to 2016 using translabyrinth approach (n=1364), retrosigmoid approach (n=173) and middle fossa approach (n=38) . 160 patients underwent serial observation. The main clinical outcomes were change in facial nerve function, pure-tone average and word recognition from pre- to postoperative and surgical complications. The anatomical location and course of the facial nerve along the tumor surface were recorded in 100 patients during the microsurgery, and were classified into 4 groups.

Results: Among surgical group, tumor total removal rate was 96.3% and good facial nerve function rate (HBI-II) one year after surgery was 87.2%. Serviceable hearing preservation rate was 63.1%. Among 40 patients with small tumor and normal hearing (interaural PTA gap ≤15dB ), serviceable hearing preservation rate was 91.1% compared to abnormal hearing group (48.2%).The facial nerve displacement was identified as the followings: Type A 46%; Type B 34%;Type C 20%;Type D 0-1%.

Conclusions: Good results can be achieved in patients with vestibular schwannoma. Surgical removal is recommended in small tumor with normal hearing. Early identification of course of the facial nerve along the tumor surface during the microsurgery is very important.

Supported by: Ear Institute, Shanghai Jiaotong University School of Medicine; Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases; Shanghai 9’th People’s Hospital, Shanghai Jiaotong University School of Medicine

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