Artikel ; Online: Contemporary surgical management of vestibular schwannomas: analysis of complications and lessons learned over the past decade.
2013 Band 72, Heft 2 Suppl Operative, Seite(n) ons103–15; discussion ons115
Abstract: Background: Despite advanced microsurgical techniques, more refined instrumentation, and expert team management, there is still a significant incidence of complications in vestibular schwannoma surgery.: Objective: To analyze complications from the ... ...
| Abstract | Background: Despite advanced microsurgical techniques, more refined instrumentation, and expert team management, there is still a significant incidence of complications in vestibular schwannoma surgery. Objective: To analyze complications from the microsurgical treatment of vestibular schwannoma by an expert surgical team and to propose strategies for minimizing such complications. Methods: Surgical outcomes and complications were evaluated in a consecutive series of 410 unilateral vestibular schwannomas treated from 2000 to 2009. Clinical status and complications were assessed postoperatively (within 7 days) and at the time of follow-up (range, 1-116 months; mean, 32.7 months). Results: Follow-up data were available for 357 of the 410 patients (87.1%). Microsurgical tumor resection was performed through a retrosigmoid approach in 70.7% of cases. Thirty-three patients (8%) had intrameatal tumors and 204 (49.8%) had tumors that were <20 mm. Gross total resection was performed in 306 patients (74.6%). Hearing preservation surgery was attempted in 170 patients with tumors <20 mm, and good hearing was preserved in 74.1%. The main neurological complication was facial palsy (House-Brackmann grade III-VI), observed in 14% of patients (56 cases) postoperatively; however, 59% of them improved during the follow-up period. Other neurological complications were disequilibrium in 6.3%, facial numbness in 2.2%, and lower cranial nerve deficit in 0.5%. Nonneurological complications included cerebrospinal fluid leaks in 7.6%, wound infection in 2.2%, and meningitis in 1.7%. Conclusion: Many of these complications are avoidable through further refinement of operative technique, and strategies for avoiding complications are proposed. |
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| Mesh-Begriff(e) | Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Neuroma, Acoustic/surgery ; Neurosurgical Procedures/adverse effects ; Neurosurgical Procedures/methods ; Postoperative Complications/epidemiology ; Retrospective Studies ; Young Adult | ||||||||||
| Sprache | Englisch | ||||||||||
| Erscheinungsdatum | 2013-06 | ||||||||||
| Erscheinungsland | United States | ||||||||||
| Dokumenttyp | Journal Article | ||||||||||
| ZDB-ID | 135446-2 | ||||||||||
| ISSN | 1524-4040 ; 0148-396X | ||||||||||
| ISSN (online) | 1524-4040 | ||||||||||
| ISSN | 0148-396X | ||||||||||
| DOI | 10.1227/NEU.0b013e3182752b05 | ||||||||||
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| Datenquelle | MEDical Literature Analysis and Retrieval System OnLINE |
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