Aim: To improve the results of treating large and giant vestibularschwannomas.
Method: A prospective study of surgical treatment of 67 consecutivepatients with vestibular schwannomas (VS) during the period from 2011 to 2016. All patients were operated on by the author of thestudy. The results of treatment were compared with the previousperiod (2006 - 2010). VSs were removed using the retrosigmoidapproach. The function of the facial nerve was analyzed. In addition, English sources on the Internet were analyzed.
Results: Two (3%) patients with medium VS, 12 (17.9%) withmoderately large VS, 31 (46.3%) with large VS and 22 (32.8%) withgiant VS were operated on. Thus, large and giant schvannomasoccurred in 79.1% of cases. Total removal of VS was performed in59 (88.1%) cases, subtotal in 7 (10.4%), and partial in 1 (1.5%) case. In the study group 2 patients died. Postoperative mortality rate - 3%.
Conclusion: In the surgical series of studies patients with large andgiant VSs, which were discovered in 79.1% of cases, predominate. The main objective of VS surgery is a maximum complete removalof the tumor while preserving function of the brain stem, bloodvessels and cranial nerves. Application of modern technologies (ultrasound aspiration, trepanation of the internal auditory canal, neuromonitoring of the facial nerve function, preoperative surgeryplanning based on multimodal operation support) allows toincrease radicality of surgeries and to improve functional outputseven for large and giant VSs
