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J Neurol Surg B Skull Base 2018; 79(03): 297-301
DOI: 10.1055/s-0037-1607976
Original Article
Georg Thieme Verlag KG Stuttgart · New York

A Cross-sectional Survey of the North American Skull Base Society on Vestibular Schwannoma, Part 2: Perioperative Practice Patterns of Vestibular Schwannoma in North America

Jamie J. Van Gompel
1   Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, United States
2   Department of Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, United States
,
Matthew L. Carlson
1   Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, United States
2   Department of Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, United States
,
R. Mark Wiet
3   Department of Otolaryngology-Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, United States
,
Nicole M. Tombers
1   Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, United States
,
Anand K. Devaiah M
4   Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, United States
,
Devyani Lal
5   Department of Otolaryngology-Head & Neck Surgery, Mayo Clinic College of Medicine, Phoenix, Arizona, United States
,
Jacques J. Morcos
6   Department of Neurological Surgery, University of Miami, Miller School of Medicine, Miami, Florida, United States
,
Michael J. Link
1   Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, United States
2   Department of Neurologic Surgery, Mayo Clinic School of Medicine, Rochester, Minnesota, United States
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Publikationsverlauf

23. April 2017

19. September 2017

Publikationsdatum:
03. November 2017 (online)

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Abstract

Introduction Perioperative care of vestibular schwannoma (VS) patients is extremely variable across surgeons and institutions making practice patterns difficult to standardize. No data currently exist detailing this practice variability.

Methods The North American Skull Base Society membership was electronically surveyed regarding perioperative care of surgically operated VS patients.

Results There were 87 respondents to the survey. Surgical positioning, surgical approach utilized, and perioperative medical adjuncts are quite variable. However, of those performing retrosigmoid approaches, 49% perform this in the supine position, while 33% use a park-bench position with only 2% using the sitting position. In those performing translabyrinthine approaches, 86% perform this in supine position. Although the use of neuromonitoring appears to be standard of care (98%), other than the seventh nerve, there is substantial variability between respondents regarding monitoring of additional cranial nerves. Postoperative antibiotics are used by 65%, postoperative steroids 81%, and postoperative chemical deep vein thrombosis prophylaxis in 68% of survey respondents.

Conclusion Although the perioperative adjuncts to VS surgery are variable, there does appear to be a trend in common practice. Therefore, making surgeons aware of these trends may lead to standardized practice or alternatively trials of these variances to instruct which truly improve patient outcomes.

Keywords

vestibular schwannoma - skull base - cranial - microsurgical

Financial Material and Support

Internal departmental funding was utilized without commercial sponsorship or support.


Institutional Review Board Approval

Institutional Review Board exempted the study.


Supplementary Material