Tear production after vestibular schwannoma surgery and intermediate nerve function

Area of Science:

• Ophthalmology
• Neurosurgery
• Audiology

Background:

• Vestibular schwannoma (VS) is a tumor affecting the vestibulocochlear nerve.
• Intermediate nerve function, including tear production, can be compromised by VS and its surgical treatment.
• Objective quantification of tear production is crucial for understanding postoperative sequelae.

Purpose of the Study:

• To objectively evaluate the impact of vestibular schwannoma (VS) surgery on tear production.
• To assess the difference in tear production between the tumor and non-tumor sides before and after VS resection.
• To correlate tear production changes with tumor size, surgical extent, and facial nerve function.

Main Methods:

• Prospective cohort study of 111 patients undergoing unilateral VS resection.
• Objective tear production measurement using the Schirmer test in both eyes.
• Univariate linear regression to correlate tear production with clinical and surgical factors.

Main Results:

• A significant increase in the difference of tear production between eyes was observed post-surgery (p < 0.001).
• Postoperative tear production difference correlated with preoperative tumor size (p = 0.039).
• 67% of patients used eye lubricants postoperatively, with lower tear production in the tumor-side eye in this group.

Conclusions:

• Vestibular schwannoma resection commonly affects tear production, leading to inter-eye differences.
• Larger tumors are associated with greater postoperative tear production asymmetry.
• Patients should be counseled on potential decreased tear production and the likelihood of requiring eye lubricants after VS surgery.