Results in a Personal Series of 160 Cases
One hundred sixty consecutive patients (mean age, 49.9 years) were operated at San Filippo Neri Hospital, Rome, between September 2010 and April 2018. Mean tumor size was 23.3 mm. One hundred thirty-five patients (84.4%) had completely preserved facial nerve function (HB 1) before surgery; 56 (35%) patients had preoperative serviceable hearing (AAO-HNS classes A/B). Retrosigmoid approach was performed in all the cases except for one, wherein the patient underwent a translabyrinthine approach. The total or near-total (thin capsule residue left on the brainstem) resection rate was obtained in majority of cases. In the last 14 surgical procedures, a flexible endoscope was employed for final check in the IAC. At 6 months after surgery, 149 (93.7%) patients had HB 1 or facial nerve function. Among 56 patients who had serviceable hearing before surgery, 35 retained it, thus yielding a hearing preservation rate of 62.5%. In 63 procedures, diluted topical papaverine was used for improving the blood flow in microvasculature of cranial nerves.
KeywordsVestibular schwannoma/surgery Vestibular schwannoma/hearing preservation Vestibular schwannoma/endoscope Vestibular schwannoma/laser Vestibular schwannoma/papaverine