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Vestibular Schwannomas

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Surgery of Cerebellopontine Lesions

Abstract

Vestibular schwannomas are the most common cerebellopontine angle tumor. They comprise 6–8 % of all intracranial tumors, 25–33 % of the posterior cranial fossa, and 80–94 % of the cerebellopontine angle tumors. The molecular cascade of events leading to vestibular schwannoma formation today is much better understood, but this knowledge is still insufficient to allow precise prediction of the individual tumor evolution. Vestibular schwannomas originate from the vestibular nerve. The exact site of origin along the nerve, however, is unknown, and their predilection for this particular nerve is still unexplained. The growth of vestibular schwannomas follows a certain pattern that traditionally has been divided into four stages: intracanalicular (intrameatal), cisternal, brain stem compressive, and hydrocephalic. Each stage correlates closely with corresponding clinical symptoms. In this chapter, the main focus is the surgical removal of vestibular schwannomas via the retrosigmoid approach. Details of the operative technique in various tumor subtypes are presented and illustrated. Hearing and facial nerve functional preservation are further main topics. At the end the complication avoidance and management are discussed.

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  1. International Neuroscience Institute INI, Hannover, Germany

    Madjid Samii

  2. Department of Neurosurgery, International Neuroscience Institute, Hannover, Germany

    Venelin Gerganov

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Samii, M., Gerganov, V. (2013). Vestibular Schwannomas. In: Surgery of Cerebellopontine Lesions. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-35422-9_5

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