Abstract
Background: Postoperative hemorrhage (POH) is a severe complication following vestibular schwannoma surgery that may require surgical treatment. The purpose of our study is to identify risk factors associated with POH and reoperation following the resection of vestibular schwannoma.Methods: We retrospectively recruited 452 vestibular schwannoma patients treated with retrosigmoid approach. The primary outcome was POH, and the secondary outcome was reoperation for POH. Clinical and radiographic data were compared by performing univariate analysis and logistic regression analysis.Results: Among the 452 patients, 37 patients (8.2%) presented with POH and14 patients (3.1%) required reoperation within a 30-day hospitalization period. The univariate analysis showed that peritumoral edema, tumor diameter >30 mm, severe postoperative hypertension, and length of hospital stay were associated with POH and reoperation for POH. Logistic regression analysis showed that peritumoral edema [odds ratio (OR) 4.042, 95% confident interval (CI) 1.830–8.926, P = 0.001] and tumor diameter >30 mm (OR 3.192, 95% CI 1.421–7.168, P = 0.005) were independent predictive factors for POH. Peritumoral edema (OR 7.071, 95% CI 2.342–21.356, P = 0.001) was an independent predictive factor for reoperation by using logistic regression analysis. Further analysis revealed that larger tumor and incomplete tumor resection were both associated with a higher incidence of peritumoral edema.Conclusion: Peritumoral edema and tumor size are independent risk factors for POH following vestibular schwannoma surgery. And larger hematoma occurs more commonly in tumors with peritumoral edema which may require reoperation. Tumor size and extent of tumor resection are associated with peritumoral edema. Close attention should be paid to high-risk patients especially for those who presented with severe postoperative hypertension.
Highlights
Vestibular schwannoma (VS) is a common benign tumor of posterior cranial fossa
The purpose of our study is to identify clinical characteristics and radiological features which are associated with postoperative hemorrhage (POH) and unplanned reoperation following the resection of vestibular schwannoma
There was a total of 37 patients with POH which were divided into the hemorrhage group, including 14 of them in the reoperation group and the other 23 patients in the nonreoperation group
Summary
Vestibular schwannoma (VS) is a common benign tumor of posterior cranial fossa. With the evolution of VS resection technology, the procedures are most often safe and well-tolerated [1, 2]. A large volume of studies focused on facial, acoustic and other nerve function preservation after the resection of VS while few articles were dedicated to describing postoperative hemorrhage (POH). This complication was not uncommon with an incidence varying from 1.7 to 8% [2,3,4,5]. Postoperative hemorrhage (POH) is a severe complication following vestibular schwannoma surgery that may require surgical treatment. The purpose of our study is to identify risk factors associated with POH and reoperation following the resection of vestibular schwannoma
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