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Surgical treatment of sporadic vestibular schwannoma in a series of 1006 patients

The management of sporadic vestibular schwannoma (VS) has evolved in the last decades. The aim of this study was to analyse the evolution in surgical outcomes of VSs operated by a neurotological team between 1990 and 2006 by different approaches. A monocentric retrospective review of medical charts...

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Autores principales: Zhang, Z., Nguyen, Y., De Seta, D., Russo, F.Y., Rey, A., Kalamarides, M., Sterkers, O., Bernardeschi, D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Pacini Editore SRL 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225797/
https://www.ncbi.nlm.nih.gov/pubmed/27600105
http://dx.doi.org/10.14639/0392-100X-1176
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author Zhang, Z.
Nguyen, Y.
De Seta, D.
Russo, F.Y.
Rey, A.
Kalamarides, M.
Sterkers, O.
Bernardeschi, D.
author_facet Zhang, Z.
Nguyen, Y.
De Seta, D.
Russo, F.Y.
Rey, A.
Kalamarides, M.
Sterkers, O.
Bernardeschi, D.
author_sort Zhang, Z.
collection PubMed
description The management of sporadic vestibular schwannoma (VS) has evolved in the last decades. The aim of this study was to analyse the evolution in surgical outcomes of VSs operated by a neurotological team between 1990 and 2006 by different approaches. A monocentric retrospective review of medical charts of 1006 patients was performed. In order to assess eventual changes and progress, the 17-years period was divided in three periods, each one comprehending 268 VS (1990-1996), 299 VS (1997-2001), and 439 VS (2002-2006). Mean follow-up was 5.9 ± 2.4 years. Overall, complete VS removal was achieved in 99.4% of cases. Mortality rate was 0.3%, meningitis and CSF leaks were observed in 1.2 % and 9 % of the cases, respectively. CSF leakage decreased from 11.6% to 7.1% between the first and last period (p < 0.01) as well as revision surgery from 3.4 % to 0.9 % (p < 0.05). Facial nerve was anatomically preserved in 97.7% of cases. At one year, a good facial nerve function was observed in 85.1% of patients (grade I and II of House-Brackmann grading scale), which ranged between the first and last period from 78.4% to 87.6% (p <0.05). At one year, hearing preservation was obtained in 61.6% of patients, which increased from the first period to the last one from 50.9% to 69.0% (p < 0.05) (class A+B+C from the AAO-HNS classification). Useful hearing (class A+B) was observed in 33.5% of cases overall, with 21.8% and 42% in the first and last period, respectively (p < 0.01). Surgical outcomes of sporadic vestibular schwannoma have improved concerning facial nerve function outcomes, hearing preservation and cerebrospinal fluid (CSF) leaks, mainly due to the neuro-otological team's experience. Functional results after complete microsurgical removal of large VS depend on experience gained on small VS removal.
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spelling pubmed-52257972017-01-27 Surgical treatment of sporadic vestibular schwannoma in a series of 1006 patients Zhang, Z. Nguyen, Y. De Seta, D. Russo, F.Y. Rey, A. Kalamarides, M. Sterkers, O. Bernardeschi, D. Acta Otorhinolaryngol Ital Otology The management of sporadic vestibular schwannoma (VS) has evolved in the last decades. The aim of this study was to analyse the evolution in surgical outcomes of VSs operated by a neurotological team between 1990 and 2006 by different approaches. A monocentric retrospective review of medical charts of 1006 patients was performed. In order to assess eventual changes and progress, the 17-years period was divided in three periods, each one comprehending 268 VS (1990-1996), 299 VS (1997-2001), and 439 VS (2002-2006). Mean follow-up was 5.9 ± 2.4 years. Overall, complete VS removal was achieved in 99.4% of cases. Mortality rate was 0.3%, meningitis and CSF leaks were observed in 1.2 % and 9 % of the cases, respectively. CSF leakage decreased from 11.6% to 7.1% between the first and last period (p < 0.01) as well as revision surgery from 3.4 % to 0.9 % (p < 0.05). Facial nerve was anatomically preserved in 97.7% of cases. At one year, a good facial nerve function was observed in 85.1% of patients (grade I and II of House-Brackmann grading scale), which ranged between the first and last period from 78.4% to 87.6% (p <0.05). At one year, hearing preservation was obtained in 61.6% of patients, which increased from the first period to the last one from 50.9% to 69.0% (p < 0.05) (class A+B+C from the AAO-HNS classification). Useful hearing (class A+B) was observed in 33.5% of cases overall, with 21.8% and 42% in the first and last period, respectively (p < 0.01). Surgical outcomes of sporadic vestibular schwannoma have improved concerning facial nerve function outcomes, hearing preservation and cerebrospinal fluid (CSF) leaks, mainly due to the neuro-otological team's experience. Functional results after complete microsurgical removal of large VS depend on experience gained on small VS removal. Pacini Editore SRL 2016-10 /pmc/articles/PMC5225797/ /pubmed/27600105 http://dx.doi.org/10.14639/0392-100X-1176 Text en © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License, which permits for noncommercial use, distribution, and reproduction in any digital medium, provided the original work is properly cited and is not altered in any way. For details, please refer to http://creativecommons.org/licenses/by-nc-nd/3.0/
spellingShingle Otology
Zhang, Z.
Nguyen, Y.
De Seta, D.
Russo, F.Y.
Rey, A.
Kalamarides, M.
Sterkers, O.
Bernardeschi, D.
Surgical treatment of sporadic vestibular schwannoma in a series of 1006 patients
title Surgical treatment of sporadic vestibular schwannoma in a series of 1006 patients
title_full Surgical treatment of sporadic vestibular schwannoma in a series of 1006 patients
title_fullStr Surgical treatment of sporadic vestibular schwannoma in a series of 1006 patients
title_full_unstemmed Surgical treatment of sporadic vestibular schwannoma in a series of 1006 patients
title_short Surgical treatment of sporadic vestibular schwannoma in a series of 1006 patients
title_sort surgical treatment of sporadic vestibular schwannoma in a series of 1006 patients
topic Otology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225797/
https://www.ncbi.nlm.nih.gov/pubmed/27600105
http://dx.doi.org/10.14639/0392-100X-1176
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