«Burr hole» microsurgery for vestibular schwannoma

Objective: To evaluate the efficacy and safety of minimally invasive «burr hole» microsurgery for vestibular schwannoma.

Methods: A retrospective analysis of postoperative outcomes in 50 consecutive patients with vestibular schwannoma was performed. All patients underwent burr hole microsurgery between 2016 and 2020.

Results: All patients satisfactorily tolerated surgical treatment. Total resection was carried out in 21 (42%) cases, almost total resection - in 21 (42%) patients (>95% of baseline volume). Subtotal resection was performed in 8 (16%) cases. Mean surgery time was 132 min (range 60-340). Postoperative deterioration of facial nerve function occurred in 20 (40%) patients. Severe dysfunction (House-Brackmann grade V-VI) was observed only in three patients. Other 17 patients had moderate dysfunction of the facial nerve (House-Brackmann grade III-IV). Useful hearing was preserved in 6 (50%) out of 12 patients with preoperative useful hearing.

Conclusions: Minimally invasive burr hole microsurgery is an effective method for vestibular schwannoma. Moreover, the proposed technique reduces surgery time due to simpler craniotomy and wound closure.