Abstract
The objective of this article is to study the outcome after translabyrinthine surgery
for vestibular schwannomas, with special focus on the facial nerve function. The study
design is a case series from a national centralized database and it is set in two
University Hospitals in Denmark. Participants were 1244 patients who underwent translabyrinthine
surgery during a period of 33 years from 1976 to 2009. Main outcome measures were
tumor removal, intraoperative facial nerve preservation, complications, and postoperative
facial nerve function. In 84% patients, the tumor was totally resected and in ~85%
the nerve was intact during surgery. During 33 years, 12 patients died from complications
to surgery and ~14% had cerebrospinal fluid leakage. Before surgery, 74 patients had
facial paresis and 46% of these improved after surgery. In patients with normal facial
function, overall ~70% had a good outcome (House-Brackmann grade 1 or 2). The chance
of a good outcome was related to tumor size with a higher the chance the smaller the
tumor, but not to the degree of tumor removal. In ~78% of the patients with facial
paresis at discharge the paresis improved over time, in ~42% from a poor to a good
function. The translabyrinthine approach is generally efficient in tumor control and
with satisfactory facial nerve outcome. With larger tumors the risk of a poor outcome
is evident and more data on patients managed with alternative strategies are warranted.
Keywords
vestibular schwannoma - translabyrinthine surgery - outcome - facial nerve
