Facial nerve function after translabyrinthine vestibular schwannoma surgery

Abstract

To evaluate the long-term facial function of patients after translabyrinthine vestibular schwannoma [VS] surgery and identify factors that influence these outcomes. A retrospective review was performed that included 580 consecutive patients who underwent translabyrinthine craniotomy for removal of VS at a tertiary referral neurotologic practice between February 2000 and July 2004. A total of 512 patients who underwent primary microsurgical treatment of sporadic unilateral VS met inclusion criteria. Patient and tumor characteristics as well as perioperative complications are described. Perioperative and long-term facial function were evaluated in 392 patients who had at least 1-year follow-up. Complication rates after translabyrinthine craniotomy for VS are low. Patients with smaller tumors have significantly better postoperative facial function than those with larger tumors. Excellent long-term facial function can be expected in the majority of patients who undergo microsurgical removal of VS via the translabyrinthine approach. Alternative treatment strategies may need to be developed for the treatment of VS > 3.5 cm in order to maximize postoperative facial function.