Early-Career Surgical Practice for Cerebellopontine Angle Tumors in the Era of Radiosurgery

Journal of Neurological Surgery. Part B, Skull Base
Giannantonio SpenaMarco Fontanella

Abstract

We analyzed the outcomes of patients with large cerebellopontine angle (CPA) tumors treated by a skull-base team in which two surgeons (one neurosurgeon and one otological surgeon) were in the beginning of their careers (<40 years old). Data of patients operated on between April 2012 and March 2016 were reviewed. All factors related to surgical training were considered. Thirty-one patients had vestibular schwannomas, while 26 had meningiomas. Mean tumor diameter was 30.6 mm (range, 23-49 mm) for schwannomas and 35 mm (range, 22-51 mm) for meningiomas. Satisfactory postoperative facial nerve function (House-Brackmann's grade I or II) was achieved in 20 (64.5%) schwannoma patients and 21 (80.7%) meningioma patients. Gross total and near-total resections (residual tumor < 5 mm) were achieved in 21 (67.7%) and 9 (29%) schwannoma patients, respectively. Gross total resection (Simpson's grade II) was achieved in 18 (69.2%) meningioma patients. In both groups, the retrosigmoid approach was the most common approach. Regarding surgical training of the two younger surgeons, during the residency period, they attended high-volume centers for CPA tumors. Application of microsurgical techniques was systematically applied from the beginning o...Continue Reading

Citations

Jul 22, 2019·Acta neurochirurgica·Giannantonio SpenaGianluca Grimod

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