Robert J Macielak1, Michael S Harris, Claudia F Kirsch, Luciano M Prevedello, Oliver F Adunka. 1. *The Ohio State University College of Medicine †Department of Otolaryngology-Head & Neck Surgery, Neurotology Division, The Ohio State University ‡Department of Radiology, Division of Neuroradiology, The Ohio State University, Columbus, Ohio.
Abstract
OBJECTIVES: To determine the influence of posterior fossa dimensions on surgical outcomes after vestibular schwannoma management. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary care academic medical center. PATIENTS: Patients with sporadic vestibular schwannomas who underwent surgical resection via retrosigmoid or translabyrinthine techniques. INTERVENTIONS: Diagnostic. MAIN OUTCOME MEASURES: One and two-way analysis of variance (ANOVAs) of the cohort based on volumetric and clinical outcome groupings. RESULTS: A total of 95 patients were identified. A one-way ANOVA looking at the entire cohort of patients showed that outcomes like surgical time (p < 0.001) and whether a Good Outcome (House-Brackmann score of 1 or 2, no complications, and a complete resection) was achieved (p = 0.009) correlated very well with preoperative tumor volume, but not with posterior fossa volume (p = 0.412 and p = 0.345, respectively). However, in medium sized tumors, House-Brackmann group was correlated with posterior fossa volume (p = 0.032). CONCLUSIONS: The present data suggest a small effect of posterior fossa size on some clinical outcomes in medium sized vestibular schwannomas.
OBJECTIVES: To determine the influence of posterior fossa dimensions on surgical outcomes after vestibular schwannoma management. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary care academic medical center. PATIENTS: Patients with sporadic vestibular schwannomas who underwent surgical resection via retrosigmoid or translabyrinthine techniques. INTERVENTIONS: Diagnostic. MAIN OUTCOME MEASURES: One and two-way analysis of variance (ANOVAs) of the cohort based on volumetric and clinical outcome groupings. RESULTS: A total of 95 patients were identified. A one-way ANOVA looking at the entire cohort of patients showed that outcomes like surgical time (p < 0.001) and whether a Good Outcome (House-Brackmann score of 1 or 2, no complications, and a complete resection) was achieved (p = 0.009) correlated very well with preoperative tumor volume, but not with posterior fossa volume (p = 0.412 and p = 0.345, respectively). However, in medium sized tumors, House-Brackmann group was correlated with posterior fossa volume (p = 0.032). CONCLUSIONS: The present data suggest a small effect of posterior fossa size on some clinical outcomes in medium sized vestibular schwannomas.