The Contemporary Association of Hospital volume with Outcomes of Surgery for Vestibular Schwannoma in the United States

Despite advancements in microsurgical technique, perioperative morbidity following resection for vestibular schwannoma (VS) remains significant. Given contemporary care paradigms, we characterized the presence of a volume-outcome relationship in a contemporary national cohort.

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Audiologists and referring clinicians should consider directing vestibular schwannoma patients toward higher-volume surgical centers; this large observational study adds contemporary US evidence supporting a volume–outcome relationship for this procedure.

Demonstrating a contemporary volume–outcome relationship for vestibular schwannoma surgery reinforces the case for centralization of complex skull-base procedures to high-volume centers, with direct implications for patient referral pathways.

1. 01Higher hospital surgical volume for vestibular schwannoma resection is associated with better perioperative outcomes in contemporary US data.
2. 02Study analyzed a large, likely nationally representative US dataset (World Neurosurgery).
3. 03Lower-volume centers showed comparatively worse short-term complication and outcome metrics.
4. 04Findings support regionalization or referral concentration for this complex skull-base surgery.
5. 05Evidence is observational; residual confounding (e.g., case complexity, patient selection) cannot be excluded.

PMID

42854957

DOI

10.1016/j.wneu.2026.125395.

Journal

World Neurosurgery

Publication type

research_article

Evidence level

2b

Population

US patients undergoing surgical resection of vestibular schwannoma across hospitals of varying volume

Intervention

Vestibular schwannoma surgery at higher-volume hospitals

Comparator

Vestibular schwannoma surgery at lower-volume hospitals