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Erschienen in:
22.05.2017 | How I Do it - Neurosurgical Techniques
Facial nerve sparing surgery for large vestibular schwannomas
Erschienen in: Acta Neurochirurgica | Ausgabe 7/2017
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Background
Nowadays, there is a general trend in vestibular schwannoma (VS) surgery favoring near-total or subtotal tumor resection (NTR/STR) with facial nerve (FN) function preservation rather than gross total resection (GTR) with high risk of FN damage.
Methods
The surgical technique of FN sparing in large VS includes patient-tailored image-guided craniotomy, continuous intraoperative neurophysiological monitoring (INM), intracapsular wide tumor debulking, and only final extracapsular dissection with FN course identification and brainstem decompression. A small amount of residual tumor along the FN is accepted in order to not damage the nerve. Postoperative radiosurgery workup is then recommended.
Conclusions
NTR/STR resection with FN function sparing is a valid option for large VS.