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Risks of Surgical Options for Vestibular Schwannoma/Acoustic Neuroma

Surgical outcomes for acoustic neuroma (vestibular schwannoma) removal can vary widely based on factors such as the surgeon’s expertise, tumor size, and the patient’s overall health status. However, I can provide some general statistics regarding potential risks associated with the different surgical approaches. Please remember these are approximate values and individual outcomes may vary:

  1. Translabyrinthine Approach: This approach provides excellent exposure of the tumor and the facial nerve, often leading to a high rate of facial nerve preservation (90-95%). However, because it involves removal of the labyrinth, it always results in total hearing loss in the affected ear.
  2. Retrosigmoid/Suboccipital Approach: This approach also has a high rate of facial nerve preservation (90-95%). The hearing preservation rate can vary widely depending on the size of the tumor and the patient’s preoperative hearing status, but it’s typically around 50-70%.
  3. Middle Fossa Approach: This approach is usually used for smaller tumors when hearing preservation is a goal. The rate of facial nerve preservation is again high (90-95%). Hearing preservation rates can be up to 70-80% when this approach is used, but again, this is highly dependent on the patient’s preoperative hearing and the size and location of the tumor.

Remember, these are only estimates. Other potential complications of surgery include issues like headache, cerebrospinal fluid leak, meningitis, balance problems, and problems with taste or swallowing.