Postoperative Complications After Surgery for Vestibular Schwannoma via the MCF Approach

Background: The aim of this study was to analyze complications after surgery for vestibular schwannoma (VS) via the middle cranial fossa (MCF) approach. Patients and methods: 112 consecutive patients have been operated on via MCF approach in our department between October 2005 and March 2011. Postoperative complications have been registered during hospital stay as well as during out-patient follow-up. Results: 25 complications occurred in 20 patients, most common was a CSF leak (12 %). In 9 cases leakage stopped after conservative management. 3 patients needed lumbar drainage and 1 patient had to undergo revision-surgery. 6 patients suffered from hemorrhage: 2 cerebellar bleedings, 1 subdural hematoma, 2 hematomas of the scalp and 1 bleeding of the sutured wound. All bleedings except the case with subdural hematoma could be managed conservatively. Furthermore, one case of meningitis and one transient ischemic attack were observed. 3 patients suffered from a deep venous thrombosis which led to a lethal pulmonary embolism in one case. Conclusions: Surgery for VS via the MCF approach is an established method with satisfying functional results and a low complication rate. CSF leak is a common complication (12 %) that can be managed conservatively in most of the cases. Severe complications that may lead to revision surgery are rare (2 %). Persisting sequels of these complications occur in less than 1 % of the cases.