[Complications and sequelae in acoustic neuroma surgery].
OBJECTIVE
To evaluate the complications and sequelae of acoustic neuroma surgery, according to tumour size.


METHODS
A retrospective analysis of 120 patients who underwent microsurgical resection of vestibular schwannomas between November 1994 and September 2006 was undertaken. Tumour size, extent of removal, preservation of facial and cochlear nerves, complications, and sequelae were considered. The degree of hearing preservation after surgery was determined by the Gardner-Robertson classification.


RESULTS
There were 39 small (<1.5 cm), 59 medium (1.5-3 cm), and 22 large tumours (>3 cm). Gross total resection was accomplished in 106 cases (88.3 %). The facial nerve was anatomically and functionally preserved in 103 cases on long-term follow-up (85.4 %). The cochlear nerve was functionally preserved (Gardner-Robertson class 1 and 2) in 54.4 % of the small tumours with useful preoperative hearing. Two patients died due to postoperative complications (mortality rate, 1.6 %), and 15 (12.5 %) developed a CSF leak.


CONCLUSIONS
Despite the progress in the surgical treatment of acoustic neuromas, a considerable rate of complications and sequelae still remains. Therefore, there is a need to balance pros and cons of surgery in each patient according to the concurrent circumstances, as well as to consider other therapeutic strategies such as radiosurgery or a wait-and-see policy.
Coca
Andrés
A
Servicio de Otorrinolaringología. Hospital Universitario Central de Asturias. Oviedo. Asturias, España. acocapelaz@yahoo.es.
Gómez
Justo R
JR
Llorente
José L
JL
Rodrigo
Juan P
JP
Núñez
Faustino
F
Sevilla
María A
MA
Suárez
Carlos
C
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000706:statistics & numerical data; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000453:epidemiology* / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies