2026 Poster Presentations
P505: ENHANCED RECOVERY AFTER SURGERY (ERAS) PROTOCOL FOR VESTIBULAR SCHWANNOMA PATIENTS: A SYSTEMATIC REVIEW
Erin Ling, BS, BA1; Aidan Vanek, BS2; Lauren Michelle, MD, MBA2; Robert Macielak, MD2; Yin Ren, MD, PhD2; Kyle Wu, MD3; Daniel Prevedello, MD3; Oliver Adunka, MD2; Desi Schoo, MD2; 1The Ohio State University College of Medicine, Columbus, Ohio; 2Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio; 3Department of Neurosurgery, The Ohio State University Wexner Medical Center, Columbus, Ohio
Introduction: Recovery after vestibular schwannoma (VS) resection is often prolonged due to the impact of surgical resection on neighboring cranial nerves, particularly the vestibulocochlear and facial nerves. ERAS protocols, though validated in other surgical fields, have not been systematically evaluated in lateral skull base surgery.
Objective: We performed a systematic review to investigate the efficacy of ERAS pathways on postoperative outcomes in patients undergoing vestibular schwannoma resection.
Methods: A literature search was performed using PubMed, Cochrane, Web of Science, Scopus, and Embase databases. Studies were included in which at least one ERAS element was utilized in adult patients undergoing surgery for VS. This search yielded zero studies that met criteria. Given that many studies combine VS with other craniotomy populations, we broadened our population criteria to include adult patients undergoing elective craniotomy. The primary outcome was the postoperative length of stay (LOS). Secondary outcomes included hearing outcomes, balance outcomes, postoperative facial nerve function, postoperative pain scores, 30-day readmissions and reoperations, and mortality.
Results: Fourteen studies were included in the analysis. VS patients were explicitly described in five of these studies (n = 69); no studies exclusively evaluated VS patients. While direct comparison of LOS was limited by the heterogeneity in reporting, all but one study reported reduced postoperative LOS in the ERAS intervention group when compared to conventional perioperative care groups. Across included studies, ERAS protocols were associated with a mean LOS reduction of 2.6 days compared with conventional care. Zero studies reported hearing, balance, or facial nerve function outcomes.
Discussion: This study highlights the limited available data regarding the use and efficacy of ERAS protocols in reducing postoperative LOS in VS patients undergoing elective craniotomy. Given the complexity of postoperative recovery after resection of VS, the development of a formal ERAS pathway may improve short- and long-term outcomes in this patient population.