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66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Friendship Meeting mit der Italienischen Gesellschaft für Neurochirurgie (SINch)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

7. - 10. Juni 2015, Karlsruhe

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Surgical treatment of 460 vestibular schwannomas: Functional results and quality of life

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  • Gabriele Schackert - Klinik für Neurochirurgie, Carl Gusatv Carus Universitätsklinikum, Technische Universität Dresden
  • Dino Podlesek - Klinik für Neurochirurgie, Carl Gusatv Carus Universitätsklinikum, Technische Universität Dresden
  • Michael Kowalski - Klinik für Neurochirurgie, Carl Gusatv Carus Universitätsklinikum, Technische Universität Dresden
  • Stephan B. Sobottka - Klinik für Neurochirurgie, Carl Gusatv Carus Universitätsklinikum, Technische Universität Dresden
  • Gilfe Reiss - Klinik für Neurochirurgie, Carl Gusatv Carus Universitätsklinikum, Technische Universität Dresden
  • Daniel Martin - Klinik für Neurochirurgie, Carl Gusatv Carus Universitätsklinikum, Technische Universität Dresden

Deutsche Gesellschaft für Neurochirurgie. 66. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Karlsruhe, 07.-10.06.2015. Düsseldorf: German Medical Science GMS Publishing House; 2015. DocMO.08.01

doi: 10.3205/15dgnc029, urn:nbn:de:0183-15dgnc0294

Veröffentlicht: 2. Juni 2015

© 2015 Schackert et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Surgical removal of vestibular schwannomas has the risk for facial nerve and hearing impairment. Whereas, small tumors are preferentially considered for “Wait and Watch” or radiotherapy / radiosurgery, large tumors causing brain stem compression are candidates for surgery. The goal of our retrospective analysis was to determine our objective functional results and to compare these with the subjective patients' satisfaction.

Method: We evaluated 460 cases that had been operated between 1994 and 2014 in our institution. All patients were classified regarding the House & Brackman Scale for facial nerve function and the Gardner Robinson Scale for hearing preservation. A questionary was send to all patients being operated since 2000, concentrating on their subjective postoperative satisfaction.

Results: 75% of our patients had large tumors grade 3 and 4. In the whole group we achieved a facial nerve function H&B 1and 2 in 79%. After 2000, we optimized our results to 86%. The hearing preservation depended on the pre-operative hearing level and the size of the tumors. For the whole group a serviceable hearing was preserved in 33%. In small tumors grade 1 and 2, the hearing was preserved in 75%, in large tumors grade 3 and 4 in 18%. Besides facial nerve dysfunction and hearing loss, the patients suffered mostly from headaches, dry eyes, and depression.

Conclusions: Surgery is the method of choice for large vestibular schwannomas. The facial nerve and hearing function can be preserved in a high percentage. However, new specific and unspecific symptoms influence the satisfaction of the patients.