{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:02:57Z","timestamp":1780131777915,"version":"3.54.0"},"reference-count":102,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>There are numerous treatment strategies in the management for large vestibular schwannomas, including resection only, staged resections, resections followed by radiosurgery, and radiosurgery only. Recent evidence has pointed toward maximal resection as being the optimum strategy to prevent tumor recurrence; however, durable tumor control through aggressive resection has been shown to occur at the expense of facial nerve function and to risk other approach-related complications. Through a retrospective analysis of their single-institution series of keyhole neurosurgical approaches for large vestibular schwannomas, the authors aim to report and justify key techniques to maximize tumor resection and reduce surgical morbidity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A retrospective chart review was performed at the Centre for Minimally Invasive Neurosurgery. All patients who had undergone a keyhole retrosigmoid approach for the resection of large vestibular schwannomas, defined as having a tumor diameter of \u2265 3.0 cm, were included in this review. Patient demographics, preoperative cranial nerve status, perioperative data, and postoperative follow-up were obtained. A review of the literature for resections of large vestibular schwannomas was also performed. The authors\u2019 institutional data were compared with the historical data from the literature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Between 2004 and 2017, 45 patients met the inclusion criteria for this retrospective chart review. When compared with findings in a historical cohort in the literature, the authors\u2019 minimally invasive, keyhole retrosigmoid technique for the resection of large vestibular schwannomas achieved higher rates of gross-total or near-total resection (100% vs 83%). Moreover, these results compare favorably with the literature in facial nerve preservation (House-Brackmann I\u2013II) at follow-up after gross-total resections (81% vs 47%, p &lt; 0.001) and near-total resections (88% vs 75%, p = 0.028). There were no approach-related complications in this series.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>It is the experience of the senior author that complete or near-complete resection of large vestibular schwannomas can be successfully achieved via a keyhole approach. In this series of 45 large vestibular schwannomas, a greater extent of resection was achieved while demonstrating high rates of facial nerve preservation and low approach-related and postoperative complications compared with the literature.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2017.11.focus17607","type":"journal-article","created":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T03:36:48Z","timestamp":1519875408000},"page":"E2","source":"Crossref","is-referenced-by-count":30,"title":["Keyhole retrosigmoid approach for large vestibular schwannomas: strategies to improve outcomes"],"prefix":"10.3171","volume":"44","author":[{"given":"Reid","family":"Hoshide","sequence":"first","affiliation":[{"name":"Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital;"},{"name":"Department of Neurosurgery, University of California, San Diego, California; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harrison","family":"Faulkner","sequence":"additional","affiliation":[{"name":"Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital;"},{"name":"Faculty of Medicine, University of New South Wales, Sydney, Australia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Teo","sequence":"additional","affiliation":[{"name":"Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital;"},{"name":"Department of Neurosurgery, North Bristol University Hospital, Bristol, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Teo","sequence":"additional","affiliation":[{"name":"Centre for Minimally Invasive Neurosurgery, Prince of Wales Private Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"Neurosurgery","first-page":"671","article-title":"Facial nerve preservation surgery for Koos grade 3 and 4 vestibular schwannomas","volume":"75","author":"Anaizi AN","year":"2014","unstructured":"Anaizi AN, Gantwerker EA, Pensak ML, Theodosopoulos PV: Facial nerve preservation surgery for Koos grade 3 and 4 vestibular schwannomas. Neurosurgery 75:671\u2013677, 2014"},{"key":"b2","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 DE","year":"2005","unstructured":"Anderson DE, Leonetti J, Wind JJ, Cribari D, Fahey K: Resection of large vestibular schwannomas: facial nerve preservation in the context of surgical approach and patient-assessed outcome. J Neurosurg 102:643\u2013649, 2005"},{"key":"b3","series-title":"Otol Neurotol","first-page":"125","article-title":"Enlarged translabyrinthine approach with transapical extension in the management of giant vestibular schwannomas: personal experience and review of literature","volume":"32","author":"Angeli RD","year":"2011","unstructured":"Angeli RD, Piccirillo E, Di Trapani G, Sequino G, Taibah A, Sanna M: Enlarged translabyrinthine approach with transapical extension in the management of giant vestibular schwannomas: personal experience and review of literature. Otol Neurotol 32:125\u2013131, 2011"},{"key":"b4","series-title":"J Neurosurg","first-page":"818","article-title":"Multisession stereotactic radiosurgery for large vestibular schwannomas","volume":"122","author":"Casentini L","year":"2015","unstructured":"Casentini L, Fornezza U, Perini Z, Perissinotto E, Colombo F: Multisession stereotactic radiosurgery for large vestibular schwannomas. J Neurosurg 122:818\u2013824, 2015"},{"key":"b5","series-title":"Laryngoscope","first-page":"1720","article-title":"Vestibular schwannoma growth: the continuing controversy","volume":"110","author":"Charabi S","year":"2000","unstructured":"Charabi S, Tos M, Thomsen J, Charabi B, Mantoni M: Vestibular schwannoma growth: the continuing controversy. Laryngoscope 110:1720\u20131725, 2000"},{"key":"b6","series-title":"Acta Otolaryngol","first-page":"1249","article-title":"Perioperative complications after translabyrinthine removal of large or giant vestibular schwannoma: outcomes for 123 patients","volume":"130","author":"Charpiot A","year":"2010","unstructured":"Charpiot A, Tringali S, Zaouche S, Ferber-Viart C, Dubreuil C: Perioperative complications after translabyrinthine removal of large or giant vestibular schwannoma: outcomes for 123 patients. Acta Otolaryngol 130:1249\u20131255, 2010"},{"key":"b7","series-title":"J Neurosurg","first-page":"1278","article-title":"The behavior of residual tumors and facial nerve outcomes after incomplete excision of vestibular schwannomas","volume":"120","author":"Chen Z","year":"2014","unstructured":"Chen Z, Prasad SC, Di Lella F, Medina M, Piccirillo E, Taibah A, : The behavior of residual tumors and facial nerve outcomes after incomplete excision of vestibular schwannomas. J Neurosurg 120:1278\u20131287, 2014"},{"key":"b8","series-title":"Md Med J","first-page":"1128","article-title":"Acoustic neuroma: summary of the NIH consensus","volume":"41","author":"Cohen RJ","year":"1992","unstructured":"Cohen RJ: Acoustic neuroma: summary of the NIH consensus. Md Med J 41:1128\u20131130, 1992"},{"key":"b9","series-title":"J Craniofac Surg","first-page":"463","article-title":"Large vestibular schwannoma resection through the suboccipital retrosigmoid keyhole approach","volume":"25","author":"Daming C","year":"2014","unstructured":"Daming C, Yiwen S, Bin Z, Yajun X, Jia Y, Rui S, : Large vestibular schwannoma resection through the suboccipital retrosigmoid keyhole approach. J Craniofac Surg 25:463\u2013468, 2014"},{"key":"b10","series-title":"ANZ J Surg","first-page":"893","article-title":"Facial nerve function and hearing preservation after retrosigmoid excision of vestibular schwannoma: Christchurch Hospital experience with 97 patients","volume":"75","author":"Darwish BS","year":"2005","unstructured":"Darwish BS, Bird PA, Goodisson DW, Bonkowski JA, MacFarlane MR: Facial nerve function and hearing preservation after retrosigmoid excision of vestibular schwannoma: Christchurch Hospital experience with 97 patients. ANZ J Surg 75:893\u2013896, 2005"},{"key":"b11","series-title":"Prog Neurol Surg","first-page":"79","article-title":"Management of large vestibular schwannomas by combined surgical resection and gamma knife radiosurgery","volume":"21","author":"Fuentes S","year":"2008","unstructured":"Fuentes S, Arkha Y, Pech-Gourg G, Grisoli F, Dufour H, Regis J: Management of large vestibular schwannomas by combined surgical resection and gamma knife radiosurgery. Prog Neurol Surg 21:79\u201382, 2008"},{"key":"b12","series-title":"J Neurosurg","first-page":"1224","article-title":"Clinicopathological factors related to regrowth of vestibular schwannoma after incomplete resection","volume":"114","author":"Fukuda M","year":"2011","unstructured":"Fukuda M, Oishi M, Hiraishi T, Natsumeda M, Fujii Y: Clinicopathological factors related to regrowth of vestibular schwannoma after incomplete resection. J Neurosurg 114:1224\u20131231, 2011"},{"key":"b13","series-title":"J Neurol Surg B","first-page":"FP-05","article-title":"Subtotal resection of large vestibular schwannoma is an effective treatment","volume":"77","author":"Georges H","year":"2016","unstructured":"Georges H, Thakur B, Argiris K, Saunders N, Hardwidge C: Subtotal resection of large vestibular schwannoma is an effective treatment. J Neurol Surg B 77:FP-05\u201305, 2016 (Abstract)"},{"issue":"3","key":"b14","series-title":"Neurosurg Focus","first-page":"E16","article-title":"Facial nerve outcomes after surgery for large vestibular schwannomas: do surgical approach and extent of resection matter?","volume":"33","author":"Gurgel RK","year":"2012","unstructured":"Gurgel RK, Dogru S, Amdur RL, Monfared A: Facial nerve outcomes after surgery for large vestibular schwannomas: do surgical approach and extent of resection matter? Neurosurg Focus 33(3):E16, 2012"},{"key":"b15","series-title":"Neurosurgery","first-page":"521","article-title":"Safety and efficacy of Gamma Knife radiosurgery for the management of Koos grade 4 vestibular schwannomas","volume":"78","author":"Iorio-Morin C","year":"2016","unstructured":"Iorio-Morin C, AlSubaie F, Mathieu D: Safety and efficacy of Gamma Knife radiosurgery for the management of Koos grade 4 vestibular schwannomas. Neurosurgery 78:521\u2013530, 2016"},{"key":"b16","series-title":"Surg Neurol","first-page":"283","article-title":"Surgery combined with radiosurgery of large acoustic neuromas","volume":"59","author":"Iwai Y","year":"2003","unstructured":"Iwai Y, Yamanaka K, Ishiguro T: Surgery combined with radiosurgery of large acoustic neuromas. Surg Neurol 59:283\u2013291, 2003"},{"key":"b17","series-title":"Surg Neurol","first-page":"370","article-title":"Current surgical results of retrosigmoid approach in extralarge vestibular schwannomas","volume":"53","author":"Jung S","year":"2000","unstructured":"Jung S, Kang SS, Kim TS, Kim HJ, Jeong SK, Kim SC, : Current surgical results of retrosigmoid approach in extralarge vestibular schwannomas. Surg Neurol 53:370\u2013378, 2000"},{"key":"b18","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 TH","year":"1999","unstructured":"Lanman TH, Brackmann DE, Hitselberger WE, Subin B: Report of 190 consecutive cases of large acoustic tumors (vestibular schwannoma) removed via the translabyrinthine approach. J Neurosurg 90:617\u2013623, 1999"},{"key":"b19","series-title":"Skull Base","first-page":"189","article-title":"Current results of the surgical management of acoustic neuroma","volume":"12","author":"Lee SH","year":"2002","unstructured":"Lee SH, Willcox TO, Buchheit WA: Current results of the surgical management of acoustic neuroma. Skull Base 12:189\u2013195, 2002"},{"key":"b20","series-title":"Clin Neurol Neurosurg","first-page":"83","article-title":"Intraoperative neuromonitoring for removal of large vestibular schwannoma: facial nerve outcome and predictive factors","volume":"133","author":"Liu SW","year":"2015","unstructured":"Liu SW, Jiang W, Zhang HQ, Li XP, Wan XY, Emmanuel B, : Intraoperative neuromonitoring for removal of large vestibular schwannoma: facial nerve outcome and predictive factors. Clin Neurol Neurosurg 133:83\u201389, 2015"},{"key":"b21","series-title":"Otol Neurotol","first-page":"224","article-title":"Translabyrinthine approach for the management of large and giant vestibular schwannomas","volume":"23","author":"Mamikoglu B","year":"2002","unstructured":"Mamikoglu B, Wiet RJ, Esquivel CR: Translabyrinthine approach for the management of large and giant vestibular schwannomas. Otol Neurotol 23:224\u2013227, 2002"},{"key":"b22","series-title":"Neurosurgery","first-page":"654","article-title":"Vestibular schwannoma: surgery or gamma knife radiosurgery? A prospective, nonrandomized study","volume":"64","author":"Myrseth E","year":"2009","unstructured":"Myrseth E, M\u00f8ller P, Pedersen PH, Lund-Johansen M: Vestibular schwannoma: surgery or gamma knife radiosurgery? A prospective, nonrandomized study. Neurosurgery 64:654\u2013663, 2009"},{"key":"b23","series-title":"Otolaryngol Clin North Am","first-page":"691","article-title":"Conservative management of acoustic neuromas","volume":"25","author":"Nedzelski JM","year":"1992","unstructured":"Nedzelski JM, Schessel DA, Pfleiderer A, Kassel EE, Rowed DW: Conservative management of acoustic neuromas. Otolaryngol Clin North Am 25:691\u2013705, 1992"},{"key":"b24","series-title":"Clin Otolaryngol Allied Sci","first-page":"93","article-title":"The conservative management of acoustic neuroma: a review of forty-four patients with magnetic resonance imaging","volume":"25","author":"O\u2019Reilly B","year":"2000","unstructured":"O\u2019Reilly B, Murray CD, Hadley DM: The conservative management of acoustic neuroma: a review of forty-four patients with magnetic resonance imaging. 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J Neurosurg 117 Suppl:69\u201377, 2012"},{"key":"b26","series-title":"Neurosurgery","first-page":"77","article-title":"Patient outcomes after vestibular schwannoma management: a prospective comparison of microsurgical resection and stereotactic radiosurgery","volume":"59","author":"Pollock BE","year":"2006","unstructured":"Pollock BE, Driscoll CL, Foote RL, Link MJ, Gorman DA, Bauch CD, : Patient outcomes after vestibular schwannoma management: a prospective comparison of microsurgical resection and stereotactic radiosurgery. 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Neuro Oncol 8:1\u201311, 2006"},{"key":"b29","series-title":"Acta Neurochir (Wien)","first-page":"697","article-title":"Microsurgical results with large vestibular schwannomas with preservation of facial and cochlear nerve function as the primary aim","volume":"147","author":"Raftopoulos C","year":"2005","unstructured":"Raftopoulos C, Abu Serieh B, Duprez T, Docquier MA, Guerit JM: Microsurgical results with large vestibular schwannomas with preservation of facial and cochlear nerve function as the primary aim. Acta Neurochir (Wien) 147:697\u2013706, 2005"},{"key":"b30","series-title":"J Neurosurg","first-page":"1126","article-title":"Staged resection of large vestibular schwannomas","volume":"116","author":"Raslan AM","year":"2012","unstructured":"Raslan AM, Liu JK, McMenomey SO, Delashaw JB Jr: Staged resection of large vestibular schwannomas. J Neurosurg 116:1126\u20131133, 2012"},{"issue":"Suppl","key":"b31","series-title":"J Neurosurg","first-page":"105","article-title":"Wait-and-see strategy compared with proactive Gamma Knife surgery in patients with intracanalicular vestibular schwannomas","volume":"113","author":"R\u00e9gis J","year":"2010","unstructured":"R\u00e9gis J, Carron R, Park MC, Soumare O, Delsanti C, Thomassin JM, : Wait-and-see strategy compared with proactive Gamma Knife surgery in patients with intracanalicular vestibular schwannomas. J Neurosurg 113 Suppl:105\u2013111, 2010"},{"key":"b32","series-title":"J Neurosurg","first-page":"1091","article-title":"Functional outcome after gamma knife surgery or microsurgery for vestibular schwannomas","volume":"97","author":"R\u00e9gis J","year":"2002","unstructured":"R\u00e9gis J, Pellet W, Delsanti C, Dufour H, Roche PH, Thomassin JM, : Functional outcome after gamma knife surgery or microsurgery for vestibular schwannomas. J Neurosurg 97:1091\u20131100, 2002"},{"key":"b33","series-title":"Skull Base","first-page":"85","article-title":"Cranial nerve preservation in surgery for large acoustic neuromas","volume":"14","author":"Roland JT","year":"2004","unstructured":"Roland JT, Fishman AJ, Golfinos JG, Cohen N, Alexiades G, Jackman AH, : Cranial nerve preservation in surgery for large acoustic neuromas. Skull Base 14:85\u201390, 2004"},{"key":"b34","series-title":"J Neurosurg","first-page":"860","article-title":"Functional outcome after complete surgical removal of giant vestibular schwannomas","volume":"112","author":"Samii M","year":"2010","unstructured":"Samii M, Gerganov VM, Samii A: Functional outcome after complete surgical removal of giant vestibular schwannomas. 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