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Updated: Mar 2, 2026
A Unified Methodological Framework for Vestibular Schwannoma Research
Published on: June 20, 2017
Facial nerve sparing surgery for large vestibular schwannomas
Paolo Ferroli1, Lorenzo Bosio1, Morgan Broggi2
1Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy.
Background:
Nowadays, there is a general trend in vestibular schwannoma (VS) surgery favoring near-total or subtotal tumor resection (NTR/STR) with facial nerve (FN) function preservation rather than gross total resection (GTR) with high risk of FN damage.
Methods:
The surgical technique of FN sparing in large VS includes patient-tailored image-guided craniotomy, continuous intraoperative neurophysiological monitoring (INM), intracapsular wide tumor debulking, and only final extracapsular dissection with FN course identification and brainstem decompression. A small amount of residual tumor along the FN is accepted in order to not damage the nerve. Postoperative radiosurgery workup is then recommended.
Conclusions:
NTR/STR resection with FN function sparing is a valid option for large VS.
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