Schwannoma surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Maneesha Nandimandalam, M.B.B.S.[2]

Overview

Surgical intervention is not recommended for the management of [disease name].

OR

Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]

OR

The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].

OR

The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

Surgery is the mainstay of treatment for [disease or malignancy].

Indications

• Surgical intervention is not recommended for the management of [disease name].

OR

• Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either:
  • [Indication 1]
  • [Indication 2]
  • [Indication 3]
• The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either:
  • [Indication 1]
  • [Indication 2]
  • [Indication 3]

Surgery

• The feasibility of surgery depends on the stage of [malignancy] at diagnosis.

OR

• Surgery is the mainstay of treatment for [disease or malignancy].

Indications, benefits and disadvantages of lateral skull base approaches for VS resection.

	Translybyrinthine	Retrosigmoid	Middle fossa
Indications	Non-serviceable hearing; any IAC or CPA VS	VS with large CPA component; medial IAC VS	Small lateral IAC VS (<0.5 cm); small medial IAC VS with < 1 cm CPA component
Advantages	Minimal brain retraction	Panoramic CPA exposure; better facial nerve and hearing preservation for medial VS	Better exposure lateral IAC
Disadvantages	Complete hearing loss; difficult approach for CPA VS ventral to porus acusticus; risk for facial nerve injury	Limited access to lateral IAC; potential for cerebellar and brainstem injury	Limited PF access; temporal lobe retraction; risk for facial nerve injury