[Operative treatment of the vestibular schwannoma (acoustic neuroma): correlation between the microsurgical approach and cranial nerve lesion].

INTRODUCTION

Vestibular schwannoma (VS) is a benign tumour of cerebellopontine angle which total microsurgical resection is considered as a complex surgery. In Bosnia, VS microsurgical resection is performed occasionally and exclusively at the University Neurosurgical Depart. in Sarajevo, but radiosurgery of these tumours is completely absent.

METHODS AND

RESULTS

The role of microsurgery in resection of VS is being presented. Through analyzed series of operated patients (MJLink), we evaluated the correlation of VII and VIII nerves postoperative lesion with different operative approaches. House-Brackmann grading scale is used for VII nerve deficit appraisal. Current postoperative results of recognized experts are compared with our series and the similar morbidity rates are found.

DISCUSSION: Microsurgery is a dominant and superior way of VS treatment. However, the most frequently used microsurgical approaches (retrosigmoid, translabyrinthine and extradural subtemporal) are still connected with certain morbidity rate, especially regarding the postoperative VII and VIII nerves lesion.

CONCLUSION

Team approach, intraoperative cranial nerves monitoring and microsurgery with utilizing different surgical approaches optimize the outcome of VS neurosurgical treatment. In Bosnia, we are just stepping in the field of serious approach to this problem.