title: Subtotal/near-total treatment of vestibular schwannomas.
abstract: OBJECTIVE
  The review evaluates current literature on subtotal and near-total resection of vestibular schwannomas.
  
  
  RESULTS
  Recent findings suggest that subtotal and near-total resection of vestibular schwannomas can be performed to improve facial nerve outcomes. This is particularly true for large tumors. Whereas postoperative facial nerve function is likely improved by partial resection, recurrence rates are higher, although they vary depending on the extent of resection. If a tumor remnant grows following partial resection, the small-volume remnant can be treated with stereotactic radiation with good tumor control rates.
  
  
  CONCLUSIONS
  Subtotal and near-total resection of vestibular schwannomas is a reasonable surgical paradigm for vestibular schwannomas which cannot be completely removed without injuring the facial nerve. Whereas facial nerve outcomes are more favorable in partial resections, the risk of recurrence increases and is proportional to the volume of residual tumor.
authors.affiliation: Division of Otolaryngology - Head and Neck Surgery, University of Utah, Utah, USA. richard.gurgel@hsc.utah.edu
authors.forename: Richard K
authors.initials: RK
authors.lastname: Gurgel
authors.forename: Philip V
authors.initials: PV
authors.lastname: Theodosopoulos
authors.forename: Robert K
authors.initials: RK
authors.lastname: Jackler
mesh_terms: D019299:Decompression, Surgical / Q000009:adverse effects / Q000379:methods; D020220:Facial Nerve Injuries / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000473:pathology / Q000601:surgery; D009416:Nerve Regeneration / Q000502:physiology; D009464:Neuroma, Acoustic / Q000473:pathology* / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods*; D018570:Risk Assessment; D016896:Treatment Outcome; D047368:Tumor Burden