gms | German Medical Science

68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

The vestibular schwannoma surgery learning curve: modern series of a young neurosurgeon

Meeting Abstract

  • Ehab Shiban - Klinikum rechts der Isar TU München , München, Deutschland
  • Suschke Viktoria - Munich, Deutschland
  • Bernhard Meyer - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Jens Lehmberg - Klinikum rechts der Isar TU München , München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMi.05.01

doi: 10.3205/17dgnc387, urn:nbn:de:0183-17dgnc3870

Published: June 9, 2017

© 2017 Shiban et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

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Objective: To demonstrate and quantify the learning curve for microsurgical removal of vestibular schawanoma by a young surgeon.

Methods: We reviewed all cases vestibular schawanoma operated by the senior author between October 2006 and May 2015. Health-related Quality of life was analysed using the EuroQOL questioner at last follow via telephone interview.

Results: 112 consecutive cases from October 2006 to May 2014 were identified. The senior author performed all surgeries. 39% were male, 61% female; mean age was 58 years (range 18-85). According to the Hannover Classification, 9% were rated as T1, 16% as T2, 34% as T3, and 41% as T4. Six patients (5%) had previous surgery, eight patients (7%) had radiotherapy and 2 patients had both surgery and radiotherapy. Complete and subtotal resections were achieved in 71% and 29% of cases, respectively. Newly developed postoperative facial nerve palsy was seen in 13 cases (11%). 10 of those 13 cases (77%) were seen during the first 40 surgeries. Hearing preservation in T1/2 schwannomas was achieved in 80%, in patients with T3 tumours in 81%, and in large T4 tumours in 65%. Six patients suffered a cerebrospinal fluid fistula (5%), one patient required a ventriculoperitoneal Shunt following surgery.

Conclusion: The learning curve in our series was evident. Facial nerve preservation correlated with surgical experience. Hearing preservation was more associated with tumor size.