Vestibular schwannomas: Surgical treatment of 67 cases in 10 years

Abstract

Vestibular Schwannomas (VS) are benign intracranial tumors, for which their current management is a matter of debate, although microsurgical treatment remains the mode of choice in the majority of cases. To describe the surgical outcome of patients operated on for a VS in a Chilean Public Hospital. A series of 67 patients treated surgically between 2002 and 2012, in the Institute of Neurosurgery Asenjo is presented. Sixty-five cases (97%) corresponded to Koos III and IV tumors, of which 52% were large (3-4 cm) or Giant (>4 cm). Forty-one cases were operated on using a retrosigmoid transmeatalapproach (61%). Total resection was achieved in 97% of the cases and subtotal in the remaining 3%. A mean six months follow-up showed that good facial function (House-Brackmann I or II) was obtained in 32.7% of the patients, and moderate function (House-Brackmann III or IV) in 42.3%. Cardiopulmonary complications were the most frequent (28%), and mortality was 1.5%. The VS are tumors that can cause significant neurological deficit in advanced stages, despite their benign nature. Surgical treatment is very complex, and must be performed by specialized teams to ensure optimal functional results.