title: Removal of large or giant sporadic vestibular schwannomas via translabyrinthine approach: a report of 115 cases.
abstract: OBJECTIVE
  The present study was a retrospective analysis of surgical outcomes of large or giant vestibular schwannomas (VSs) via a translabyrinthine approach (TLA).
  
  
  METHODS
  One hundred and fifteen sporadic large or giant VSs (maximal diameter in the cerebellopontine angle ≥31 mm) were operated via TLA between January 2001 and December 2010. We divided patients into two groups: cystic VS (CVS) and solid VS (SVS) group. The surgical outcomes were recorded and compared.
  
  
  RESULTS
  Total, near total, and subtotal tumor removal rate was 89.6, 7.8, and 2.6%, respectively. The near total removal rate in CVS was higher than that in SVS (16.7 vs. 3.8%). The anatomical facial nerve (FN) integrity was preserved in 101 patients (87.8%). More FNs in CVS were interrupted (22.2%). There were 29.6, 56.5, and 13.9% of patients who had a short-term (1 month) FN function of House-Brackmann grade I or II, III or IV, and V or VI, respectively. The CVS had worse FN function than the SVS group. The mortality rate was 0.9%. Cerebrospinal fluid leakage occurred in 8 patients (7.0%). Four (3.5%) patients had recurrence.
  
  
  CONCLUSIONS
  Cyst formation is a crucial factor for surgical outcome of VS. With near total or subtotal tumor removal, worse functional outcomes in large or giant CVSs should be foreseen.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors.forename: Zhihua
authors.initials: Z
authors.lastname: Zhang
authors.forename: Zhaoyan
authors.initials: Z
authors.lastname: Wang
authors.forename: Qi
authors.initials: Q
authors.lastname: Huang
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.forename: Hao
authors.initials: H
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D007758:Ear, Inner / Q000601:surgery*; D005154:Facial Nerve / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods*; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D020127:Recovery of Function; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult