{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T20:22:37Z","timestamp":1789503757720,"version":"build-2803163510"},"reference-count":41,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2010,4]]},"abstract":"<jats:sec>\n<jats:title>Object<\/jats:title>\n<jats:p>The authors evaluated the outcome of radical surgery in a consecutive series of patients with giant vestibular schwannomas (VSs).<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>Fifty patients with VSs &gt; 4.0 cm in maximal extrameatal diameter were included in this retrospective study (Group A). The group was compared with a matched group of 167 patients with VSs &lt; 3.9 cm (Group B). In all cases the retrosigmoid approach was used. Outcome measures included completeness of tumor removal, facial nerve function, hearing, and the surgery-related complication rate.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>The mean tumor size in Group A was 4.4 cm and that in Group B was 2.3 cm. Total removal was achieved in all Group A patients and in 97.6% of Group B patients. The anatomical integrity of the facial nerve was preserved in 92% in Group A and in 98.8% in Group B. At last follow-up 75% of the patients with giant VSs had excellent or good facial nerve function, 19% had fair function, and 6% had poor function. In 33% of patients (3 cases) with good preoperative hearing level, it was preserved. Newly developed lower cranial nerve dysfunction occurred in 3 patients but proved to be temporary in 2 of them. A CSF leak developed in 6% of those who not previously undergone surgery. Compared with Group B, a significant difference was found only in the rates of the following parameters: excellent facial nerve function, useful and good hearing, lower cranial nerve dysfunction, and blood collection (p &lt; 0.05). The perioperative mortality rate in both groups was 0%.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In patients with a giant VS, total tumor removal can be achieved via the retrosigmoid approach with a 0% mortality rate and low morbidity rate, especially with regards to facial nerve function. In selected cases even hearing preservation is possible. Tumor size significantly correlates with postoperative outcome.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2009.7.jns0989","type":"journal-article","created":{"date-parts":[[2009,8,7]],"date-time":"2009-08-07T12:12:58Z","timestamp":1249647178000},"page":"860-867","source":"Crossref","is-referenced-by-count":195,"title":["Functional outcome after complete surgical removal of giant vestibular schwannomas"],"prefix":"10.3171","volume":"112","author":[{"given":"Madjid","family":"Samii","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Venelin M.","family":"Gerganov","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir","family":"Samii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-1120860","series-title":"Skull Base","first-page":"199","article-title":"Staged resection of large hypervascular vestibular schwannomas in young adults","volume":"11","author":"Abe","year":"2001"},{"key":"b2-1120860","series-title":"J Neurosurg","first-page":"643","article-title":"Resection of large vestibular schwannomas: facial nerve preservation in the context of surgical approach and patient-assessed outcome","volume":"102","author":"Anderson","year":"2005"},{"key":"b3-1120860","series-title":"Otolaryngol Clin North Am","first-page":"311","article-title":"Translabyrinthine approach for acoustic tumor removal","volume":"25","author":"Brackmann","year":"1992"},{"key":"b4-1120860","series-title":"J Neurosurg","first-page":"217","article-title":"Cerebrospinal fluid leak after acoustic neuroma surgery: influence of tumor size and surgical approach on incidence and response to treatment","volume":"94","author":"Brennan","year":"2001"},{"key":"b5-1120860","series-title":"Neurosurgery","first-page":"785","article-title":"Translabyrinthine removal of large acoustic neuromas","volume":"34","author":"Briggs","year":"1994"},{"key":"b6-1120860","series-title":"Otolaryngol Head Neck Surg","first-page":"81","article-title":"Cerebrospinal fluid leaks and meningitis in acoustic neuroma surgery","volume":"104","author":"Bryce","year":"1991"},{"key":"b7-1120860","series-title":"J Neurosurg","first-page":"901","article-title":"Current results of the retrosigmoid approach to acoustic neurinoma","volume":"76","author":"Ebersold","year":"1992"},{"key":"b8-1120860","series-title":"Acta Neurochir (Wien)","first-page":"771","article-title":"Preservation of hearing in large acoustic neurinomas following removal via suboccipitolateral approach","volume":"140","author":"Fahlbusch","year":"1998"},{"key":"b9-1120860","series-title":"Clin Neurosurg","first-page":"589","article-title":"Translabyrinthine approach for removal of medium and large tumors of the cerebellopontine angle","volume":"38","author":"Giannotta","year":"1992"},{"key":"b10-1120860","series-title":"J Neurosurg","first-page":"864","article-title":"Preservation of hearing in surgery for acoustic neuromas","volume":"78","author":"Glasscock","year":"1993"},{"key":"b11-1120860","series-title":"Neurosurgery","first-page":"50","article-title":"Acoustic neuroma: results of current surgical management","volume":"41","author":"Gormley","year":"1997"},{"key":"b12-1120860","series-title":"Laryngoscope","first-page":"1122","article-title":"Hearing preservation after acoustic neuroma resection with tumor size used as a clinical prognosticator","volume":"107","author":"Hecht","year":"1997"},{"key":"b13-1120860","series-title":"Otolaryngol Head Neck Surg","first-page":"146","article-title":"Facial nerve grading system","volume":"93","author":"House","year":"1985"},{"key":"b14-1120860","series-title":"Surg Neurol","first-page":"283","article-title":"Surgery combined with radiosurgery of large acoustic neuromas","volume":"59","author":"Iwai","year":"2003"},{"key":"b15-1120860","series-title":"Neurol India","first-page":"41","article-title":"Surgery of vestibular schwannomas: an institutional experience","volume":"53","author":"Jain","year":"2005"},{"key":"b16-1120860","series-title":"Surg Neurol","first-page":"370","article-title":"Current surgical results of retrosigmoid approach in extralarge vestibular schwannomas","volume":"53","author":"Jung","year":"2000"},{"key":"b17-1120860","series-title":"Otol Neurotol","first-page":"642","article-title":"New and modified reporting systems from the consensus meeting on systems for reporting results in vestibular schwannoma (vestibular problems)","volume":"24","author":"Kanzaki","year":"2003"},{"key":"b18-1120860","series-title":"J Neurosurg","first-page":"617","article-title":"Report of 190 consecutive cases of large acoustic tumors (vestibular schwannoma) removed via the translabyrinthine approach","volume":"90","author":"Lanman","year":"1999"},{"key":"b19-1120860","series-title":"J Neurosurg","first-page":"422","article-title":"Radical intracapsular removal of acoustic neurinomas. 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