Abstract
BACKGROUND: There are few published prospective data sets specifically focusing on patients younger than 40 years old undergoing microsurgery for vestibular schwannoma. OBJECTIVE: We describe functional outcomes and long-term tumor control after surgery in patients younger than 40 years old enrolled in a prospectively collected database over a 25-year period. METHODS: We selected all vestibular schwannoma patients from a prospectively collected database who were younger than 40 years old at the time of surgical resection for a vestibular schwannoma. Rates of tumor control and hearing preservation were analyzed using Kaplan-Meier analysis, and risk factors for facial nerve palsy, hearing loss, and trigeminal neuropathy were analyzed using multivariate logistic regression. RESULTS: A total of 204 patients younger than 40 years of age met our inclusion criteria and were included in the analysis. Our data indicate that surgical resection leads to durable long-term freedom from tumor recurrence or progression in 89% of young patients at 15 years of follow-up. Consistent with other published series, hearing was preserved in 68% of patients with smaller tumors (<3 cm). Facial nerve function was preserved in 76% of patients with smaller tumors and 52% of patients with larger tumors (P < .001). On multivariate logistic regression, tumor size was a significant predictor of hearing loss, whereas gross total resection was nearly a significant predictor of hearing loss controlling for other variables (P = .06). CONCLUSION: We present the largest prospectively studied cohort of young patients undergoing microsurgical resection of vestibular schwannoma. These data suggest that surgical resection provides excellent long-term tumor control in these patients.
Original language | English (US) |
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Pages (from-to) | 1646-1653 |
Number of pages | 8 |
Journal | Neurosurgery |
Volume | 67 |
Issue number | 6 |
DOIs | |
State | Published - Dec 2010 |
Externally published | Yes |
Keywords
- Acoustic neuroma
- Long term
- Microsurgery
- Outcome
- Vestibular schwannoma
- Young
ASJC Scopus subject areas
- Surgery
- Clinical Neurology