{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T14:26:35Z","timestamp":1782311195933,"version":"3.54.5"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,5,26]],"date-time":"2016-05-26T00:00:00Z","timestamp":1464220800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2017,2]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To evaluate the biological behaviour of tumour remnants intentionally left in the surgical bed following the incomplete excision of vestibular schwannomas (VS) and to review the relation between extent of resection and preservation of facial nerve function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective chart review of 450 patients who underwent surgery for resection of VS over 23 years (1992\u20132014). Of these, 50 (11%) patients had residual tumour intentionally left on\/around the facial nerve (near\u2010total or subtotal excision) to preserve facial nerve function intra\u2010operatively. The growth of residual tumour was evaluated using serial magnetic resonance imaging scanning; pre\u2010 and postoperative facial nerve function was assessed using the House\u2010Brackmann grading scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary referral neurotology unit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 42 non\u2010NF2 cases where the tumour was intentionally incompletely excised, 28 (67%) patients underwent subtotal resection (mean follow\u2010up 68.5 \u00b1 39.0 months) and 14 (33%) underwent near\u2010total resection (mean follow\u2010up 72.9 \u00b1 48.3 months). Three patients (all in subtotal resection group) showed regrowth. This was not statistically different from the near\u2010total resection group (<jats:italic>\u03c7<\/jats:italic><jats:sup><jats:italic>2<\/jats:italic><\/jats:sup> = 0.92, <jats:italic>P<\/jats:italic> = 0.31). The mean overall growth for these cases was 0.68 mm \u00b1 0.32 mm\/year.<\/jats:p><jats:p>5 (one near total, four subtotal) of the eight NF2 patients (62.5%) were excluded from our analysis.<\/jats:p><jats:p>In the non\u2010NF2 group, poor facial nerve outcomes (House\u2010Brackmann scores of <jats:styled-content style=\"fixed-case\">III<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">IV<\/jats:styled-content>) were seen in 2\/14 and V\u2010<jats:styled-content style=\"fixed-case\">VI<\/jats:styled-content> in 3\/14 of the near total compared with 7\/25 and 4\/25 respectively in the subtotal group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Given that the primary surgery for the VS was only for tumours that were relatively large or grew during conservative treatment, the low rate of tumour remnant growth (7%) is reassuring. It may be appropriate to have a lower threshold for leaving tumour on the facial nerve in non\u2010NF2 patients where complete resection may jeopardise facial nerve function.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.12670","type":"journal-article","created":{"date-parts":[[2016,5,9]],"date-time":"2016-05-09T18:57:30Z","timestamp":1462820250000},"page":"92-97","source":"Crossref","is-referenced-by-count":22,"title":["The behaviour of residual tumour after the intentional incomplete excision of a vestibular schwannoma: is it such a bad thing to leave some behind?"],"prefix":"10.1111","volume":"42","author":[{"given":"M.I.","family":"Syed","sequence":"first","affiliation":[{"name":"TWJ fellow in Otology\/Neurotology University Health Network  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Wolf","sequence":"additional","affiliation":[{"name":"Otology\/Neurotology University Health Network  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Ilan","sequence":"additional","affiliation":[{"name":"Otology\/Neurotology University Health Network  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6901-0985","authenticated-orcid":false,"given":"C.O.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Otology\/Neurotology University Health Network  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Chung","sequence":"additional","affiliation":[{"name":"Otology\/Neurotology University Health Network  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Tymianski","sequence":"additional","affiliation":[{"name":"Neurosurgery University Health Network  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7607-4562","authenticated-orcid":false,"given":"D.D.","family":"Pothier","sequence":"additional","affiliation":[{"name":"Otology\/Neurotology University Health Network  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.A.","family":"Rutka","sequence":"additional","affiliation":[{"name":"Otology\/Neurotology University Health Network  Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,5,26]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2273.2004.00852.x"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200004000-00002"},{"key":"e_1_2_10_4_1","first-page":"21","article-title":"The natural history of untreated vestibular schwannomas. 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