Vestibular schwannoma surgery in the ninth decade of life: a case series

Background and purpose

Large symptomatic Vestibular Schwannoma (VS) often requires surgical resection, regardless the patient’s age. The aim of this study was to assess the surgical outcomes of patients in their ninth decade of life.

Methods

This monocenter retrospective observational study included patients aged 80 years or older who underwent VS surgery between 2009 and 2020. We retrospectively analyzed their immediate post-surgical and long-term outcomes and complications.

Results

Thirteen octogenarians who underwent VS surgery were included, with average age of 83.2 ± 1.97 years old (median 83.5, range 80–86 years). One patient had a Koos-Grade II tumor, and 12 patients had a grade IV. All patients had a preoperative ASA score ≤ 3 and underwent surgery in the supine position. Twelve patients underwent a pre-planned partial resection (PR) and one had a gross-total resection (GTR). Good facial function (House-Brackmann grade ≤ 2) was achieved in 10 patients (77%). We reported three Clavien-Dindo grade ≤ 3 treatment-related complications and no life-threatening complication. Two patients experienced tumor recurrence after PR.

Conclusion

In this series of patients who underwent VS surgery in their ninth decade of life, surgical outcomes were acceptable. Therefore, age alone should not serve as a contraindication for surgery. Preplanned PR is a reasonable attitude in elderly patients.