# The outcome of the retrosigmoid approach in the decompression of vestibular schwannomas – a retrospective cohort study of 60 consecutive cases

## TL;DR

This study evaluates the effectiveness of a specific surgical approach for treating vestibular schwannomas, focusing on outcomes like hearing loss, facial nerve function, and recovery.

## Contribution

The study provides a detailed analysis of outcomes from a specific surgical approach for vestibular schwannomas using a large cohort.

## Key findings

- Hearing loss was observed in 80% of patients, primarily progressive.
- Facial nerve function was affected in 35% postoperatively, with severity linked to resection extent.
- Balance disorders improved, especially in patients with larger tumors.

## Abstract

This multicenter retrospective cohort study aimed to evaluate the effectiveness of the retrosigmoid surgical approach in decompressing vestibular schwannomas, focusing on tumor decompression, neurological function preservation, and postoperative complications. A cohort of 60 patients, operated between 2016 and 2019, was analyzed for age, sex, symptoms, tumor size, surgery duration, complications, mortality, and facial/auditory functions using established criteria. Hearing loss was observed in 80% of patients, mainly progressive, with tumor size emerging as a critical prognostic factor. Facial weakness affected 10% of patients preoperatively; postoperatively, 35% of patients had affected facial nerve function, with 10% exhibiting poor or no facial nerve function, linked to resection extent rather than tumor size. Tinnitus was more prevalent with larger tumors, whereas headaches were common irrespective of size. Balance disorders improved after surgery, especially in case of larger tumors. Functional recovery varied, with 41.67% of patients returning to their previous activity within 4 months, 25% within 4–12 months, and 33.33% remaining inactive. The mortality rate was low at 3.3 %, with two deaths out of 60 patients after surgery. This analysis highlights surgery risks for vestibular schwannomas (e.g., facial nerve decline, tinnitus, headaches), but also emphasizes benefits like improved balance and low mortality. Many patients regain professional activity, stressing the importance of informed treatment decisions for this condition.