2025 Poster Presentations
P472: COMPARING OUTCOMES OF SOLO NEUROSURGICAL VERSUS MULTIDISCIPLINARY APPROACHES IN RETROSIGMOID RESECTION OF VESTIBULAR SCHWANNOMAS
Kurbaan S Shergill; Brian D Westerberg, MD, MHSc, FRCSC; Ryojo Akagami, MD, BSc, MHSc, FRCSC; Serge Makarenko, MD, FRCSC; University of British Columbia
Introduction: Vestibular Schwannomas (VS) are surgically managed using retrosigmoid, translabyrinthine, and middle cranial fossa approaches. Multidisciplinary approaches combining neurosurgery and neuro-otology are critical to improve surgical outcomes. However, in some circumstances, a combined surgical team approach is not possible, and empirical evidence directly comparing these multidisciplinary approaches to solo surgical interventions is limited.
Objective: This study compares surgical outcomes in resection of VS with the retrosigmoid approach with and without involvement of a subspecialized neuro-otologist.
Methods: A retrospective cohort study was conducted at a single quaternary hospital, assessing patients who underwent retrosigmoid VS resections between 2001 and 2023. The outcomes of interest were postoperative House-Brackman facial nerve scores, hearing preservation, operative time, blood loss, extent of resection, and length of hospital stay.
Results: 65 out of a much larger cohort of patients who underwent retrosigmoid VS resection have been assessed so far; of 65 cases, 50 were operated on by both a neurosurgeon and a neuro-otologist, and 15 by neurosurgeons alone. Preliminary analysis revealed no statistically significant differences in hearing preservation, House-Brackman scores, operative time, or blood loss between the groups. The incidence of residual tumors was lower in the multidisciplinary group (34.78%) compared to the solo group (61.54%), although this difference was not statistically significant (p=0.16). The mean length of hospital stay was shorter for the multidisciplinary group (3.82 days) compared to the solo group (5.27 days), but this difference also did not reach statistical significance (p=0.106).
Conclusion: We observe a trend towards greater rate of resection and a shorter hospital stay with a multidisciplinary team consisting of a neurosurgeon and a neuro-otologist compared to neurosurgeons operating alone.