title: Evolution of vestibular schwannoma surgery: the long journey to current success.
abstract: The extraordinary improvement of patient outcome after surgical treatment for vestibular schwannomas is relatively recent and has occurred mainly over the last 30 years. The introduction of microsurgical techniques has resulted in increasing degrees of precise anatomical and functional preservation of the facial and cochlear nerves. An expanded microsurgical technique accompanied by continuous electrophysiological monitoring has resulted in marked changes in the primary goals for this surgery. Whereas in the past the primary goal of vestibular schwannoma management was to preserve the patient's life, the objective in vestibular schwannoma treatment today is to preserve neurological function. Long-term follow-up examinations show negligible recurrence rates, indicating that the aim of preservation of nerve function does not limit the completeness of tumor removal with modern neurosurgical techniques. Despite these advances in preserving the anatomical integrity of, for example, the cochlear nerve, losses of function and even deafness may occur postoperatively in some cases. Current biological and technical research in experimental and clinical settings addresses these problems. In this article, the authors report in detail the developments achieved in vestibular schwannoma surgery and the great clinicians to whom these results can be credited.
authors.affiliation: Department of Neurosurgery, International Neuroscience Institute, Hannover, Germany. andrei.koerbel@med.uni-tuebingen.de
authors.forename: Andrei
authors.initials: A
authors.lastname: Koerbel
authors.forename: Alireza
authors.initials: A
authors.lastname: Gharabaghi
authors.forename: Sam
authors.initials: S
authors.lastname: Safavi-Abbasi
authors.forename: Marcos
authors.initials: M
authors.lastname: Tatagiba
authors.forename: Madjid
authors.initials: M
authors.lastname: Samii
mesh_terms: D003638:Deafness / Q000209:etiology / Q000517:prevention & control; D020220:Facial Nerve Injuries / Q000209:etiology / Q000517:prevention & control; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D008866:Microsurgery / Q000266:history* / Q000379:methods; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009464:Neuroma, Acoustic / Q000266:history* / Q000601:surgery*; D009493:Neurosurgery / Q000266:history* / Q000379:methods; D019635:Neurosurgical Procedures / Q000266:history* / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D000159:Vestibulocochlear Nerve / Q000473:pathology / Q000601:surgery*; D061285:Vestibulocochlear Nerve Injuries