Management of Complications in Vestibular Schwannoma Surgery

Otolaryngol Clin North Am. 2023 Jun;56(3):567-576. doi: 10.1016/j.otc.2023.02.015. Epub 2023 Mar 22.

Abstract

Microsurgical removal of acoustic neuroma has advanced tremendously; however, complications still occur. Facial nerve injury is the most common detrimental complication and should take precedence over gross tumor removal in cases where there is an unfavorable tumor-facial nerve interface. Cerebrospinal fluid leakage can occur even with meticulous closure techniques and is generally treatable with either lumbar-subarachnoid drainage or revision wound closure. Meningitis is a serious complication that requires a high index of suspicion in the postoperative period. Other less common complications include intraoperative and postoperative vascular injuries. Early identification and treatment can prevent devastating outcomes.

Keywords: Cerebrospinal fluid leak; Complications; Facial nerve paralysis; Meningitis; Vestibular schwannoma.

Publication types

  • Review

MeSH terms

  • Cerebrospinal Fluid Leak / etiology
  • Cerebrospinal Fluid Leak / therapy
  • Facial Nerve
  • Facial Nerve Injuries* / complications
  • Humans
  • Neuroma, Acoustic* / surgery
  • Postoperative Complications / etiology
  • Retrospective Studies