RSS-Feed abonnieren
DOI: 10.1055/s-0037-1600606
The Vestibular Schwannoma Surgery Learning Curve: Modern Series of a Young Neurosurgeon
Publikationsverlauf
Publikationsdatum:
02. März 2017 (online)
Objective: To demonstrate and quantify the learning curve for microsurgical removal of vestibular schwannoma by a young surgeon.
Methods: We reviewed all cases vestibular schwannoma operated by the senior author between October 2006 and May 2015. Health-related Quality of life was analyzed using the EuroQOL questioner at last follow via telephone interview.
Results: 112 consecutive cases from October 2006 to May 2014 were identified. The senior author performed all surgeries. 39% were male, 61% female; mean age was 58 years (range 18–85). According to the Hannover Classification, 9% were rated as T1, 16% as T2, 34% as T3, and 41% as T4. Six patients (5%) had previous surgery, eight patients (7%) had radiotherapy and 2 patients had both surgery and radiotherapy. Complete and subtotal resections were achieved in 71% and 29% of cases, respectively. Newly developed postoperative facial nerve palsy was seen in 13 cases (11%). 10 of those 13 cases (77%) were seen during the first 40 surgeries. Hearing preservation in T1/2 schwannomas was achieved in 80%, in patients with T3 tumors in 81%, and in large T4 tumors in 65%. Six patients suffered a cerebrospinal fluid fistula (5%), one patient required a ventriculoperitoneal Shunt follow surgery.
Conclusion: The learning curve in our series was evident. Facial nerve preservation correlated with surgical experience. Hearing preservation was more associated with tumor size.
Die Autoren geben an, dass kein Interessenkonflikt besteht.