title: Surgical treatment of vestibular schwannoma. Review of 420 cases.
abstract: OBJECTIVE
  Vestibular schwannoma is the most frequent cerebellopontine angle tumor. The aim of our study is to reflect our experience in the surgical treatment of this tumor
  
  
  METHODS
  Retrospective study of 420 vestibular schwannomas operated in our hospital between 1994-2014. We include tumor size, preoperative hearing, surgical approaches, definitive facial and hearing functional results, and complications due to surgery.
  
  
  RESULTS
  A total of 417 patients with 420 tumors were analyzed, 209 female (50.1%) and 208 male (49.9%). Mean age at diagnosis was 49.8±13.2 years. The majority of the tumors were resected through a translabyrinthine approach (80.2%). Total tumor removal was achieved in 411 tumors (98.3%), and anatomic preservation of facial nerve in 404 (96.2%). Definitive facial nerve outcome was House-Brackmann grade I and II in 69.9%, and was significantly better in tumors under 20mm. Surgical complications included cerebrospinal fluid leakage in 3 patients (0.7%) and retroauricular subcutaneous collection in 16 (3.8%), 5 cases of meningitis (1.2%), 4 patients with intracraneal bleeding (0.9%), and death in 3 patients (0.7%).
  
  
  CONCLUSIONS
  Surgery is the treatment of choice for vestibular schwannoma in the majority of patients. In our experience, the complication rate is very low and tumor size is the main factor influencing postoperative facial nerve function.
authors.affiliation: Servicio de ORL, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Arístegui Ruiz
authors.affiliation: Servicio de ORL, Hospital General Universitario Gregorio Marañón, Madrid, España. Electronic address: ricardomorujo@hotmail.com.
authors.forename: Ricardo José
authors.initials: RJ
authors.lastname: González-Orús Álvarez-Morujo
authors.affiliation: Servicio de ORL, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Carlos Martín
authors.initials: CM
authors.lastname: Oviedo
authors.affiliation: Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Ruiz-Juretschke
authors.affiliation: Servicio de Neurocirugía, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Roberto
authors.initials: R
authors.lastname: García Leal
authors.affiliation: Servicio de ORL, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Bartolomé
authors.initials: B
authors.lastname: Scola Yurrita
mesh_terms: D000328:Adult; D065634:Cerebrospinal Fluid Leak / Q000453:epidemiology / Q000209:etiology; D020220:Facial Nerve Injuries / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000209:etiology; D006801:Humans; D020300:Intracranial Hemorrhages / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008581:Meningitis / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000401:mortality; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden
keywords: Acoustic neuroma; Complicaciones; Complications; Facial nerve; Nervio facial; Neurinoma del acústico; Schwannoma vestibular; Surgical treatment; Tratamiento quirúrgico; Vestibular schwannoma