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Updated: Jul 17, 2025
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A Unified Methodological Framework for Vestibular Schwannoma Research
Published on: June 20, 2017
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Generating Operative Workflows for Vestibular Schwannoma Resection: A Two-Stage Delphi's Consensus in Collaboration
Hugo Layard Horsfall1,2, Danyal Z Khan1,2, Justin Collins3
1Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, United Kingdom.
Journal of Neurological Surgery. Part B, Skull Base
|September 6, 2023
Summary
This study outlines a structured operative workflow for retrosigmoid approach vestibular schwannoma resection. It details phases, steps, and potential errors to enhance surgical training and understanding.
Area of Science:
- Neurosurgery
- Skull Base Surgery
Background:
- Operative workflows standardize surgical procedures.
- Understanding surgical variation is crucial for training and education.
Purpose of the Study:
- To present a codified operative workflow for the retrosigmoid approach to vestibular schwannoma resection.
- To establish a foundation for surgical education and analysis.
Main Methods:
- A mixed-method consensus process involving literature review and Delphi consensus.
- Collaboration with the British Skull Base Society (BSBS).
- Repeated Delphi rounds until data saturation and >90% consensus.
Main Results:
- Eighteen experienced skull base surgeons participated.
- A 40-step operative workflow was developed for the retrosigmoid approach.
- Workflow includes three phases: approach/exposure, debulking/excision, and closure.
- Technique and event errors were identified for each step.
Conclusions:
- A national, consensus-derived, codified operative workflow for retrosigmoid vestibular schwannoma resection is presented.
- This workflow encompasses phases, steps, instruments, and error types.
- Serves as foundational research for neurosurgical simulation, education, and workflow analysis.
