Beyond audiofacial morbidity after vestibular schwannoma surgery: Clinical article

Michael E. Sughrue, Isaac Yang, Derick Aranda, Martin J. Rutkowski, Shanna Fang, Steven W. Cheung, Andrew T. Parsa

Research output: Contribution to journalArticle

Abstract

Object. Outcomes following vestibular schwannoma (VS) surgery have been extensively described; however, complication rates reported in the literature vary markedly. In addition, the majority of reports have focused on outcomes related to cranial nerves (CNs) VII and VIII. The objective of this study was to analyze reported morbidity unrelated to CNs VII and VIII following the resection of VS. Methods. The authors performed a comprehensive search of the English language literature, identifying and aggregating morbidity and death data from patients who had undergone microsurgical removal of VSs. A subgroup analysis based on surgical approach and tumor size was performed to compare rates of CSF leakage, vascular injury, neurological deficit, and postoperative infection. Results. One hundred articles met the inclusion criteria, providing data for 32,870 patients. The overall mortality rate was 0.2% (95% CI 0.1-0.3%). Twenty-two percent of patients (95% CI 21-23%) experienced at least 1 surgically attributable complication unrelated to CNs VII or VIII. Cerebrospinal fluid leakage occurred in 8.5% of patients (95% CI 6.9-10.0%). This rate was markedly increased with the translabyrinthine approach but was not affected by tumor size. Vascular complications, such as ischemic injury or hemorrhage, occurred in 1% of patients (95% CI 0.75-1.2%). Neurological complications occurred in 8.6% of cases (95% CI 7.9-9.3%) and were less likely with the resection of smaller tumors (p < 0.0001) and the use of the translabyrinthine approach (p < 0.0001). Infections occurred in 3.8% of cases (95% CI 3.4-4.3%), and 78% of these infections were meningitis. Conclusions. This study provides statistically powerful data for practitioners to advise patients about the published risks of surgery for VS unrelated to compromised CNs VII and VIII.

Original languageEnglish (US)
Pages (from-to)367-374
Number of pages8
JournalJournal of neurosurgery
Volume114
Issue number2
DOIs
StatePublished - Feb 1 2011
Externally publishedYes

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Acoustic Neuroma
Vestibulocochlear Nerve
Facial Nerve
Morbidity
Infection
Neoplasms
Vascular System Injuries
Meningitis
Blood Vessels
Language
Hemorrhage
Mortality
Wounds and Injuries

Keywords

  • Acoustic neuroma
  • Morbidity
  • Review
  • Vestibular schwannoma

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Sughrue, M. E., Yang, I., Aranda, D., Rutkowski, M. J., Fang, S., Cheung, S. W., & Parsa, A. T. (2011). Beyond audiofacial morbidity after vestibular schwannoma surgery: Clinical article. Journal of neurosurgery, 114(2), 367-374. https://doi.org/10.3171/2009.10.JNS091203

Beyond audiofacial morbidity after vestibular schwannoma surgery : Clinical article. / Sughrue, Michael E.; Yang, Isaac; Aranda, Derick; Rutkowski, Martin J.; Fang, Shanna; Cheung, Steven W.; Parsa, Andrew T.

In: Journal of neurosurgery, Vol. 114, No. 2, 01.02.2011, p. 367-374.

Research output: Contribution to journalArticle

Sughrue, ME, Yang, I, Aranda, D, Rutkowski, MJ, Fang, S, Cheung, SW & Parsa, AT 2011, 'Beyond audiofacial morbidity after vestibular schwannoma surgery: Clinical article', Journal of neurosurgery, vol. 114, no. 2, pp. 367-374. https://doi.org/10.3171/2009.10.JNS091203
Sughrue ME, Yang I, Aranda D, Rutkowski MJ, Fang S, Cheung SW et al. Beyond audiofacial morbidity after vestibular schwannoma surgery: Clinical article. Journal of neurosurgery. 2011 Feb 1;114(2):367-374. https://doi.org/10.3171/2009.10.JNS091203
Sughrue, Michael E. ; Yang, Isaac ; Aranda, Derick ; Rutkowski, Martin J. ; Fang, Shanna ; Cheung, Steven W. ; Parsa, Andrew T. / Beyond audiofacial morbidity after vestibular schwannoma surgery : Clinical article. In: Journal of neurosurgery. 2011 ; Vol. 114, No. 2. pp. 367-374.
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