Surgical outcomes of vestibular schwannoma in the low-volume center

Background: This study aims to evaluate retrospectively the surgical outcomes and associated complications of vestibular schwannoma in a low-volume, single-center institution. We intend to discuss strategies that may improve clinical outcomes in the surgical treatment of vestibular schwan-noma in low-volume medical centers and the correlation between the case volume of medical center and clinical outcomes. Materials and Methods: From January 2018 to December 2022, 13 patients (5 males and 8 fe-males; median age, 66 years) underwent surgery for vestibular schwannoma. The surgeries were performed by a single surgeon who initiated the clinical practice. The median length of tumors was 35 mm (range, 13-55 mm). Results: Among 13 patients, 10 patients (76.9%) underwent retromastoid suboccipital craniotomy, 3 patients (23.1%) underwent translabyrinthine approach, 4 patients (30.8%) underwent subtotal resection, 6 patients (46.2%) underwent near-total resection, and 3 patients (23.1%) underwent gross total resection. The facial nerve preservation rate was 84.6% (n = 11). Hearing preservation rate was 30.7% (n = 4). Conclusions: The surgical outcomes of vestibular schwannoma are not directly influenced by the volume of the medical institution. Instead, they are dependent on factors such as proper surgical planning, appropriate selection of surgical approaches and using intraoperative monitoring.