Surgical Management of Vestibular Schwannomas and Hearing Rehabilitation in Neurofibromatosis Type 2

Abstract

By following a policy of treating VS in NF2 patients where tumor growth is observed, complete tumor resection can be achieved through a translabyrinthine approach while achieving comparable facial nerve outcomes to published series. We advocate proactive hearing rehabilitation in all patients with timely assessment for auditory implantation to maintain quality of life.

Neurofibromatosis 2 Invasion of the Internal Auditory Canal Wall

“…Endoscopy of the IAC after tumor removal might assist the surgeon in detecting tumor remnants that have invaded the bone and facilitate complete tumor resection, reducing recurrence rates. 19, 20 …”

Neurofibromatosis Type 2 Vestibular Schwannoma Treatment

“…Transient to permanent damage of these structures is possible after MS, although rates vary according to tumor size and location, and have decreased with the improvement of microsurgical techniques (17,24,47). Complete hearing loss can also occur, even in an attempt at hearing preservation techniques.…”

Current Concepts in Management of Vestibular Schwannomas in Neurofibromatosis Type 2

“…However, failure of adjuvant therapy to control tumour growth is then likely to require revision surgery with a substantially higher risk of permanent nerve dysfunction than after a primary surgical procedure. Balancing all of these factors requires an experienced multidisciplinary team and a detailed patient counselling [15]. An advantage of undertaking such surgery in high-volume specialist centres is the possibility of offering brainstem implantation in suitable cases.…”