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CC BY-NC-ND 4.0 · J Neurol Surg Rep 2023; 84(04): e140-e143
DOI: 10.1055/s-0043-1776124
Original Report

Repeat Surgery for Vestibular Schwannomas: An Institutional Case Series

Khizar R. Nandoliya 
1   Department of Neurological Surgery, Malnati Brain Tumor Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
,
Emily J. Winterhalter
1   Department of Neurological Surgery, Malnati Brain Tumor Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
,
Constantine L. Karras
1   Department of Neurological Surgery, Malnati Brain Tumor Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
,
Rushmin Khazanchi
1   Department of Neurological Surgery, Malnati Brain Tumor Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
,
Mark W. Youngblood
1   Department of Neurological Surgery, Malnati Brain Tumor Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
,
Pavlos Texakalidis
1   Department of Neurological Surgery, Malnati Brain Tumor Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
,
James P. Chandler
1   Department of Neurological Surgery, Malnati Brain Tumor Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
,
Stephen T. Magill 
1   Department of Neurological Surgery, Malnati Brain Tumor Institute, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States
› Author Affiliations Funding This study was supported by the Northwestern Medicine Malnati Brain Tumor Institute of the Lurie Cancer Center to S.T.M. No part of this work has been previously published.
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Abstract

Introduction Vestibular schwannomas (VSs) are treated with microsurgery and/or radiosurgery. Repeat resection is rare, and few studies have reported postoperative outcomes. The objective of this study was to describe clinical characteristics and outcomes in patients undergoing repeat surgery for VS.

Methods All adult (≥ 18 years) patients undergoing VS resection between 2003 and 2022 at our institution were retrospectively reviewed to identify patients who underwent repeat surgery of an ipsilateral VS following prior gross-total (GTR) or subtotal resection. Patient, radiographic, and clinical characteristics were reviewed. Primary outcomes were postoperative tumor volume, extent of resection, postoperative cranial nerve deficits, and time to further tumor progression.

Results Of 102 patients undergoing VS resection, 6 (5.9%) had undergone repeat surgery. Median (range) follow-up was 20 (5–117) months. Three patients were female. Median age was 56 (36–60) years. Median pre- and postoperative tumor volumes were 8.2 (1.8–28.2) cm3 and 0.4 (0–3.8) cm3. GTR was achieved in two patients. Four patients had higher House-Brackmann scores at last follow-up, but none had tumor progression.

Conclusion In this small cohort of patients, repeat resection of recurrent or progressive VS can effectively reduce tumor volume with acceptable perioperative outcomes.

Keywords

acoustic neuroma - microsurgery - repeat surgery - vestibular schwannoma


Publication History

Received: 05 February 2023

Accepted: 03 September 2023

Article published online:
27 October 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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