Between January 2003 and December 2006, 103 consecutive patients who had undergone VS resection were included in this study. Medical records, operation summaries, follow-up data, and neuroradiological findings were analyzed. The relationship between tumor size, location, and topography relative to the facial nerve bundles was studied for a mean duration of 16 months (range: 3–39 months).
Complete tumor resection in combination with anatomic preservation of the facial nerve was achieved in 101 (98.1 % ) cases. The facial nerve was fully preserved in 100 % of cases with small or medium tumors and in 37/39 patients with large tumors. Overall, 83.5 % of patients had normal or near-normal facial nerve function 3–12 months post-surgically. The mortality rate was 0 % .
Even in large VS, preservation of facial nerve function (H-B Grade I or II) should be prioritized over total resection. For tumors >3 cm, the goal of low morbidity and maintenance of normal facial nerve function can be attained with the retrosigmoid transmeatal approach, refined microsurgical technique, and intraoperative facial nerve monitoring.