Clinical spectrum and postoperative outcome of patients with unilateral vestibular schwannoma
23 April 2019 (online)
The Vestibular Schwannoma (VS) causes various symptoms due to its variable position along the 8th cranial nerve. There exist 3 therapeutic options: wait-and-scan, radiation and surgery via 3 possible approaches, which can lead to various complications. Our aim is to categorize the data on the characteristics of the VS, the diagnostics, therapies and complications in order to create an overview of the clinical picture and to find correlations.
Material and methods:
A retrospective analysis was performed on 128 patients (p) with unilateral VS who were treated at the University Hospital Freiburg during the last 10 years.
The most common symptom was hearing loss (85.7%, n = 108), but also tinnitus (75.2%, n = 94) and vertigo (40.8%, n = 51) were often reported, as well as headaches, sudden hearing loss, loss of sensitivity and others. The tumor was mainly intrameatal (41%, n = 50) and its largest extension was on average (o.a.) 13.2 mm. 27 P (21.4%, n = 27) were controlled by wait-and-scan for o.a. 3.65 years and 9.5% (n = 12) were treated by radiotherapy. Most p (90.5%, n = 114) were surgically treated – some secondary after "wait-and-scan" or irradiation – via different approaches: 60.4% (n = 64) translabyrinthine, 30.2% (n = 32) suboccipital and 9.4% (n = 10) subtemporal. Postoperatively, complications occurred in 81.7% (n = 89) of p, most frequently facial paresis (50.6%, n = 45). Other complications were headache, cerebrospinal fluid fistula, tinnitus, surditas and dizziness.
The most common symptom was hearing loss, which is in line with literature. Despite many therapeutic options, primary or secondary surgery is most frequently used. Facial paresis as the most common complication is also found in the literature.