Evolution of techniques for the resection of vestibular schwannomas: from saving life to saving function.
The current state of surgery for vestibular schwannomas (VSs) is the result of a century of step-by-step technical progress by groundbreaking surgeons who transformed the procedure from its hazardous infancy and high mortality rate to its current state of safety and low morbidity rate. Harvey Cushing advocated bilateral suboccipital decompression and developed the method of intracapsular tumor enucleation. Walter Dandy supported the unilateral suboccipital approach and developed the technique of gross-total tumor resection. Microsurgical techniques revolutionized VS surgery to its current status. In this article, the authors review the early history of surgery for VSs with an emphasis on contributions from pioneering surgeons. The authors examined the Cushing Brain Tumor Registry for clues regarding the bona fide intention of Cushing for the resection of these tumors.
Akard
William
W
Clarian Neuroscience Institute, Indianapolis Neurosurgical Group, Inc., and Department of Neurosurgery, Indiana University, Indianapolis, Indiana, USA.
Tubbs
R Shane
RS
Seymour
Zachary A
ZA
Hitselberger
William E
WE
Cohen-Gadol
Aaron A
AA
D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008866:Microsurgery / Q000266:history; D009464:Neuroma, Acoustic / Q000266:history* / Q000601:surgery; D019635:Neurosurgical Procedures / Q000266:history*