title: Complications of microsurgery of vestibular schwannoma.
abstract: BACKGROUND
  The aim of this study was to analyze complications of vestibular schwannoma (VS) microsurgery.
  
  
  METHODS
  A retrospective study was performed in 333 patients with unilateral vestibular schwannoma indicated for surgical treatment between January 1997 and December 2012. Postoperative complications were assessed immediately after VS surgery as well as during outpatient followup.
  
  
  RESULTS
  In all 333 patients microsurgical vestibular schwannoma (Koos grade 1: 12, grade 2: 34, grade 3: 62, and grade 4: 225) removal was performed. The main neurological complication was facial nerve dysfunction. The intermediate and poor function (HB III-VI) was observed in 124 cases (45%) immediately after surgery and in 104 cases (33%) on the last followup. We encountered disordered vestibular compensation in 13%, permanent trigeminal nerve dysfunction in 1%, and transient lower cranial nerves (IX-XI) deficit in 6%. Nonneurological complications included CSF leakage in 63% (lateral/medial variant: 99/1%), headache in 9%, and intracerebral hemorrhage in 5%. We did not encounter any case of meningitis.
  
  
  CONCLUSIONS
  Our study demonstrates that despite the benefits of advanced high-tech equipment, refined microsurgical instruments, and highly developed neuroimaging technologies, there are still various and significant complications associated with vestibular schwannomas microsurgery.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Faculty Hospital Motol, Charles University in Prague, V Uvalu 84, Prague 5, 150 06 Prague, Czech Republic.
authors.forename: Jan
authors.identifier: 0000-0001-8772-317X
authors.initials: J
authors.lastname: Betka
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Faculty Hospital Motol, Charles University in Prague, V Uvalu 84, Prague 5, 150 06 Prague, Czech Republic.
authors.forename: Eduard
authors.initials: E
authors.lastname: Zvěřina
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Faculty Hospital Motol, Charles University in Prague, V Uvalu 84, Prague 5, 150 06 Prague, Czech Republic ; Department of Auditory Neuroscience, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Videnska 1083, Prague 4, 142 20 Prague, Czech Republic.
authors.forename: Zuzana
authors.initials: Z
authors.lastname: Balogová
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Faculty Hospital Motol, Charles University in Prague, V Uvalu 84, Prague 5, 150 06 Prague, Czech Republic ; Department of Auditory Neuroscience, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Videnska 1083, Prague 4, 142 20 Prague, Czech Republic.
authors.forename: Oliver
authors.identifier: 0000-0002-7738-1791
authors.initials: O
authors.lastname: Profant
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Faculty Hospital Motol, Charles University in Prague, V Uvalu 84, Prague 5, 150 06 Prague, Czech Republic.
authors.forename: Jiří
authors.initials: J
authors.lastname: Skřivan
authors.affiliation: Department of Pediatric Neurology, 2nd Faculty of Medicine, Faculty Hospital Motol, Charles University in Prague, V Uvalu 84, Prague 5, 150 06 Prague, Czech Republic.
authors.forename: Josef
authors.initials: J
authors.lastname: Kraus
authors.affiliation: Department of Imaging Methods, 2nd Faculty of Medicine, Faculty Hospital Motol, Charles University, V Uvalu 84, Prague 5 150 06, Prague, Czech Republic.
authors.forename: Jiří
authors.identifier: 0000-0001-7284-8586
authors.initials: J
authors.lastname: Lisý
authors.affiliation: Department of Auditory Neuroscience, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Videnska 1083, Prague 4, 142 20 Prague, Czech Republic.
authors.forename: Josef
authors.initials: J
authors.lastname: Syka
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Faculty Hospital Motol, Charles University in Prague, V Uvalu 84, Prague 5, 150 06 Prague, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Chovanec
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D002648:Child; D004428:Ear Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D005155:Facial Nerve Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006261:Headache / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000009:adverse effects*; D008875:Middle Aged; D009442:Neurilemmoma / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D011859:Radiography; D012189:Retrospective Studies; D015837:Vestibular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*