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A Unified Methodological Framework for Vestibular Schwannoma Research
Published on: June 20, 2017
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Facial Nerve Preserving Subtotal Excision for Large Vestibular Schwannoma: An Institution-Based Functional Outcome
Santhosh K S Annayappa1, A R Prabhuraj, A Arivazhagan
1Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.
Neurology India
|August 31, 2024
Summary
Subtotal excision of large vestibular schwannomas (VS) with or without Gamma Knife radiosurgery (GKRS) preserves facial nerve function. This approach offers good tumor control and facial nerve outcomes, but long-term recurrence monitoring is essential.
Area of Science:
- Neurosurgery
- Oncology
- Otolaryngology
Background:
- Complete resection of medium to large vestibular schwannomas (VS) aims for cranial nerve preservation.
- Facial nerve dysfunction risk after total VS resection ranges from 31% to 57%.
- Treatment goals for large VS are shifting towards prioritizing facial nerve preservation over complete tumor removal.
Purpose of the Study:
- To assess facial nerve outcomes in patients with large VS treated with subtotal excision.
- To evaluate the efficacy of subtotal excision with or without Gamma Knife radiosurgery (GKRS) for large VS.
Main Methods:
- Retrospective analysis of patients with large VS undergoing primary surgery (January 2012 - December 2016).
- Inclusion criteria: subtotal excision with residual tumor to prevent facial nerve injury.
- 52 patients meeting criteria were analyzed.
Main Results:
- 70% of patients achieved good facial nerve function (H-B grade 1-2) at final follow-up.
- 81% of patients with preoperative normal facial nerve function maintained good outcomes.
- 62% of patients with preoperative deficits either maintained or improved their facial nerve function.
Conclusions:
- Subtotal excision of VS followed by GKRS provides good facial nerve outcomes and tumor control.
- Long-term surveillance is necessary to monitor for potential recurrences of these slow-growing tumors.
