Single-stage retrosigmoid versus translabyrinthine resection of vestibular schwannomas: impact of tumor volume on surgical, functional, and radiological outcomes

In this study, the authors aimed to compare surgical, functional, and radiological outcomes between retrosigmoid (RS) and translabyrinthine (TL) approaches for single-stage vestibular schwannoma (VS) resection, and to evaluate the influence of tumor volume (TV) and anatomical grade.

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Tumour volume significantly influences outcomes in single-stage vestibular schwannoma surgery; surgeons should factor tumour size when selecting between retrosigmoid and translabyrinthine approaches, but audiologists have no direct practice change from this finding.

Clearer evidence on how tumour volume drives outcome differences between the two dominant surgical approaches can refine multidisciplinary treatment planning for vestibular schwannoma patients.

1. 01Retrospective study in J Neurosurg compares retrosigmoid vs. translabyrinthine vestibular schwannoma resection.
2. 02Tumour volume is a key factor affecting surgical, functional, and radiological outcomes.
3. 03Translabyrinthine approach sacrifices residual hearing; retrosigmoid may preserve it in select cases.
4. 04Facial nerve outcomes and extent of resection may differ by approach and tumour size.
5. 05Findings support individualized surgical approach selection based on tumour volume.

PMID

42537238

DOI

10.3171/2026.2.JNS252437.

Journal

Journal of Neurosurgery

Publication type

research_article

Evidence level

4

Population

Patients undergoing single-stage surgical resection of vestibular schwannomas

Intervention

Single-stage retrosigmoid resection of vestibular schwannoma

Comparator

Single-stage translabyrinthine resection of vestibular schwannoma