Mislav Gjuric1, Milan Rudic. 1. Department of Otorhinolaryngology, KBC Zagreb, University of Zagreb, Zagreb, Croatia.
Abstract
OBJECTIVES: To analyze our own functional results to delineate a critical vestibular schwannoma size for middle cranial fossa (MCF) surgery with the best possible outcome. STUDY DESIGN: Retrospective chart review. SETTING: Academic tertiary referral center. METHODS: Tumors were divided into intracanalicular, tumors 1 to 5, 6 to 10, and 11 to 15 mm in the cerebellopontine angle (CPA). Patients were evaluated at 2 months, 1 year, and 5 years after surgery. RESULTS: At 1 year, House-Brackmann score of I or II was obtained in 100% of intracanalicular and in 96%, 86%, and 85% with tumors up to 5, 10, and 15 mm in the CPA, respectively. Class I hearing was postoperatively preserved in 61%, 41%, 29%, and 20%, and measurable word recognition in 67%, 51%, 35%, and 21% of patients, respectively. CONCLUSION: The outcome is predominantly a function of tumor size, and these changes influence MCF surgery at an earlier stage than in the translabyrinthine or retrosigmoid approach. For the facial nerve, there is a cutoff at 5-mm extracanalicular extension. Also, chances for successful hearing preservation decrease rapidly with size, and in tumors beyond 1.5 cm are below 20%. Consequently, although an expectant policy with small tumors may be reasonable in some instances, it is not so for MCF candidates.
OBJECTIVES: To analyze our own functional results to delineate a critical vestibular schwannoma size for middle cranial fossa (MCF) surgery with the best possible outcome. STUDY DESIGN: Retrospective chart review. SETTING: Academic tertiary referral center. METHODS:Tumors were divided into intracanalicular, tumors 1 to 5, 6 to 10, and 11 to 15 mm in the cerebellopontine angle (CPA). Patients were evaluated at 2 months, 1 year, and 5 years after surgery. RESULTS: At 1 year, House-Brackmann score of I or II was obtained in 100% of intracanalicular and in 96%, 86%, and 85% with tumors up to 5, 10, and 15 mm in the CPA, respectively. Class I hearing was postoperatively preserved in 61%, 41%, 29%, and 20%, and measurable word recognition in 67%, 51%, 35%, and 21% of patients, respectively. CONCLUSION: The outcome is predominantly a function of tumor size, and these changes influence MCF surgery at an earlier stage than in the translabyrinthine or retrosigmoid approach. For the facial nerve, there is a cutoff at 5-mm extracanalicular extension. Also, chances for successful hearing preservation decrease rapidly with size, and in tumors beyond 1.5 cm are below 20%. Consequently, although an expectant policy with small tumors may be reasonable in some instances, it is not so for MCF candidates.
Authors: Ted A Meyer; Paul A Canty; Eric P Wilkinson; Marlan R Hansen; Jay T Rubinstein; Bruce J Gantz Journal: Otol Neurotol Date: 2006-04 Impact factor: 2.311
Authors: E Zanoletti; D Cazzador; C Faccioli; S Gallo; L Denaro; D D'Avella; A Martini; A Mazzoni Journal: Acta Otorhinolaryngol Ital Date: 2018-08 Impact factor: 2.124