Perioperative complications after translabyrinthine removal of large or giant vestibular schwannoma: Outcomes for 123 patients

Conclusion: Large vestibular schwannomas are benign but dangerous tumors. The translabyrinthine approach allows the surgeon to limit vital and functional complications due to the disease itself or to its surgical removal. Objective: Morbi-mortality study focused on large vestibular schwannoma surgically treated by translabyrinthine removal. Methods: This was a retrospective review of prospectively collected data in a series of 123 patients who underwent translabyrinthine removal of a large vestibular schwannoma (>4 cm in the cerebellopontine angle, stage IV). All surgical and medical complications and facial function were reviewed, with a 1-year follow-up. Results: Mortality during the first year was 0.8% (one case of infarct of the anterior inferior cerebellar artery, fatal after 8 months). In all, 4.9% of patients underwent a second surgery (for delayed hemorrhage or cerebrospinal fluid leak) during the first months after removal of a large vestibular schwannoma; 3.2% of patients experienced definitive neurologic complications (one death, one cerebellar disturbance, and two cases of 10th cranial nerve palsy).