527 fully endoscopic resections of vestibular schwannomas.

Background: We report a series of 527 patients with unilateral vestibular schwannomas (VS) who underwent fully endoscopic resection of their tumors during the period of October, 2001 to July, 2010. Patients ' outcomes were evaluated, with specifi c regard to hearing preservation, facial nerve function, postoperative complica- tions and completeness of the resection. Methods: The patient population consisted of 527 cases with unilateral VS(s); patients with neurofi bromatosis type 2 (NFT2) were excluded from this study. Tumors ranged in size from 0.3 - 5.8 cm, most tumors were less than 4 cm in diameter (mean: 2.8 cm). Tumors were removed via 2.0 cm " keyhole " retrosigmoid craniotomies. Results: Utilizing the fully endoscopic tech- nique, 94 % of tumors were completely removed; subtotal removal was performed in 6 % of patients in an attempt to preserve their hear- ing. Anatomic preservation of the facial nerve was achieved in all of the patients. Functionally, measurable hearing (serviceable / some) was pre- served in 57 % of cases that had either " service- able " or " some " hearing pre-operatively. There were no major neurological complications such as quadriparesis, hemiparesis, bacterial or asep- tic meningitis, permanent lower cranial nerve defi cits, or deaths. Conclusion: From our experience, we conclude that the endoscope is ideally suited for a mini- mally invasive approach for resection of vestibu- lar schwannomas.