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BackgroundVestibular schwannomas (VS) are usually hypovascularized. Large VS with unusual vascular architecture are defined hyper-vascular (HVVS); excessive bleeding during microsurgery has negative impact on results. Methods Thirty-two consecutive patients were operated on for HVVS (Group-A). Results were compared with those of 25 patients (Group-B) operated on for large low-bleeding VS. Tendency to bleed and adherence of capsule to nervous structures were evaluated by reviewing video records. Cisternal facial nerve (FN) position was reported. Microsurgical removal was classified as total, near-total, subtotal or partial and MIB-1 index evaluated in all. FN results were classified according the House-Brackmann scale.Results Mean tumor diameter was 3,99cm in Group-A and 3,67 in Group-B; mean age was 42,3 and 58,1 years, respectively. Mean ASA class of Group-A was 1,72 versus 2,48 of Group-B (pConclusions Microsurgery of large HVVS was associated with higher complication and recurrence/re-growth rate and poorer FN outcome, especially in cases with tight capsule adhesion. |
