Table of Contents Author Guidelines Submit a Manuscript
BioMed Research International
Volume 2014 (2014), Article ID 315952, 10 pages
http://dx.doi.org/10.1155/2014/315952
Clinical Study

Complications of Microsurgery of Vestibular Schwannoma

1Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Faculty Hospital Motol, Charles University in Prague, V Uvalu 84, Prague 5, 150 06 Prague, Czech Republic
2Department of Auditory Neuroscience, Institute of Experimental Medicine, Academy of Sciences of the Czech Republic, Videnska 1083, Prague 4, 142 20 Prague, Czech Republic
3Department of Pediatric Neurology, 2nd Faculty of Medicine, Faculty Hospital Motol, Charles University in Prague, V Uvalu 84, Prague 5, 150 06 Prague, Czech Republic
4Department of Imaging Methods, 2nd Faculty of Medicine, Faculty Hospital Motol, Charles University, V Uvalu 84, Prague 5 150 06, Prague, Czech Republic

Received 7 February 2014; Accepted 29 April 2014; Published 28 May 2014

Academic Editor: Jan Plzak

Copyright © 2014 Jan Betka et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. The aim of this study was to analyze complications of vestibular schwannoma (VS) microsurgery. Material and Methods. A retrospective study was performed in 333 patients with unilateral vestibular schwannoma indicated for surgical treatment between January 1997 and December 2012. Postoperative complications were assessed immediately after VS surgery as well as during outpatient followup. Results. In all 333 patients microsurgical vestibular schwannoma (Koos grade 1: 12, grade 2: 34, grade 3: 62, and grade 4: 225) removal was performed. The main neurological complication was facial nerve dysfunction. The intermediate and poor function (HB III–VI) was observed in 124 cases (45%) immediately after surgery and in 104 cases (33%) on the last followup. We encountered disordered vestibular compensation in 13%, permanent trigeminal nerve dysfunction in 1%, and transient lower cranial nerves (IX–XI) deficit in 6%. Nonneurological complications included CSF leakage in 63% (lateral/medial variant: 99/1%), headache in 9%, and intracerebral hemorrhage in 5%. We did not encounter any case of meningitis. Conclusions. Our study demonstrates that despite the benefits of advanced high-tech equipment, refined microsurgical instruments, and highly developed neuroimaging technologies, there are still various and significant complications associated with vestibular schwannomas microsurgery.