Clinical comparison of two subtypes of cystic vestibular schwannoma: surgical considerations and outcomes.
Cystic vestibular schwannoma (CVS) is classified as Type A and Type B based on the overall cyst location and cyst wall thickness in magnetic resonance imaging. A retrospective analysis was performed to compare surgical considerations and outcomes between Type A and Type B groups of CVS. We selected 188 patients diagnostic for CVS with surgical resection, and divided them into Type A and Type B groups. General information, preoperative symptoms, the result of neuroimaging, and audiological tests were recorded. Surgical approach, completeness of tumor resection, and intraoperative facial nerve (FN) integrity were taken down. After operation, the short-term and long-term FN functions, complications, and recurrence rate were evaluated. The total tumor removal rate in Type A group was higher than that in Type B group (86.1 vs 72.5 %, p = 0.021). Anatomical FN integrity was preserved in 173 patients (92.0 %), with no significant differences between Type A and Type B. FN function was better in Type A group at hospital discharge. Besides, a good FN function rate was inversely proportional to the tumor size. The long-term FN function and all of the complications had no significant differences between the two groups. Patients in the Type B group are prone to have a lower total tumor removal rate and transient FN dysfunction. The long-term FN function was similar in both groups. Tumor size is another important indication of FN function. All postoperative complications occurred in patients with a tumor larger than grade 3, regardless of the subtypes of CVS.
Ear Institute, Shanghai Jiaotong University, Shanghai, China.|Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China.|Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Zirong
Z
Huo
Ear Institute, Shanghai Jiaotong University, Shanghai, China.|Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China.|Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Zhihua
Z
Zhang
Ear Institute, Shanghai Jiaotong University, Shanghai, China.|Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China.|Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Qi
Q
Huang
Ear Institute, Shanghai Jiaotong University, Shanghai, China.|Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China.|Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
Jun
J
Yang
Ear Institute, Shanghai Jiaotong University, Shanghai, China.|Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China.|Department of Otolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Raod, Yangpu District, Shanghai, 200092, China.
Zhaoyan
Z
Wang
Ear Institute, Shanghai Jiaotong University, Shanghai, China.|Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China.|Department of Otolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Raod, Yangpu District, Shanghai, 200092, China.
Huan
H
Jia
Ear Institute, Shanghai Jiaotong University, Shanghai, China. entwuhao622@sina.com.|Shanghai Key Laboratory of Translational Medicine on Ear and Nose diseases, Shanghai, China. entwuhao622@sina.com.|Department of Otolaryngology Head and Neck Surgery, Xinhua Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China. entwuhao622@sina.com.|Department of Otolaryngology Head and Neck Surgery, Shanghai Ninth People's Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Raod, Yangpu District, Shanghai, 200092, China. entwuhao622@sina.com.
Hao
H
Wu
D000293:Adolescent; D000328:Adult; D000368:Aged; D003389:Cranial Nerve Diseases / Q000209:etiology; D005155:Facial Nerve Diseases / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local; D009464:Neuroma, Acoustic / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D055815:Young Adult
Complication; Cystic vestibular schwannoma; Facial nerve function; Surgical outcome