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Skull Base 2002; 12(4): 189-196
DOI: 10.1055/s-2002-35750
ORIGINAL ARTICLE

Copyright © 2002 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Current Results of the Surgical Management of Acoustic Neuroma

Sun H. Lee1 , Thomas O. Willcox2  Jr. , William A. Buchheit3
  • 1Division of Neurosurgery, UMDNJ-Robert Wood Johnson University Hospital, New Brunswick, New Jersey
  • 2Department of Otolaryngology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
  • 3Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania
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Publication History

Publication Date:
14 May 2004 (online)

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ABSTRACT

A retrospective analysis of 162 consecutive cases in 160 patients who underwent microsurgical resection of vestibular schwannomas between October 1995 and June 2001 was undertaken to compare the results with those of other treatment modalities. Patient hospital records, operative video pictures, neuroimaging studies, audiograms, and follow-up data were reviewed. The mean follow-up period was 24 months.

There were 34 small (<1.5 cm), 92 medium (1.5-3 cm), and 36 (>3 cm) large tumors. Six were recurrent tumors. Gross total resection was accomplished in all 34 small tumors and 92 medium tumors but only in 50% of the large tumors. Among the 126 small and medium tumors, the facial nerve was saved anatomically in 124 patients. On long-term follow up, facial function was preserved in 94.4% of all patients. Anatomically, the cochlear nerve was preserved in 55.9% of the small and 20.7% of the medium tumors. Function was preserved (Gardner-Robertson class 1 and 2) in 25% of the small and in 19.4% of the medium tumors. Cerebrospinal leakage was present in 10.5%, meningitis in 9.9%, wound infection in 3.7%, and hematoma or contusion in 2.5%. Only one patient died (mortality rate 0.6%). Our data reflect that surgical removal should be the standard management for acoustic tumors, particularly for large and medium tumors, and can be accomplished with acceptable complication rates.

KEYWORDS

Acoustic neuroma - complications - surgical outcome

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