Vestibular schwannoma surgery and inner ear injuries
Reviewed by Hassan Mohammed

Iatrogenic inner ear injury during vestibular schwannoma (VS) surgery ranges between 20% and 30% in the literature. However, there is no up-to-date quantification of such injuries, hence this study. The authors conducted a US-multicentre database search looking for patients who underwent surgery for VS between 1993 and 2015. A total of 1153 patients who underwent either a middle fossa or a retro-sigmoid resection were included. Of these patients, 93% underwent a retro-sigmoid approach. Reviewing and combining the data from the operation notes and the postoperative computed tomography (CT) scans when available, showed that 248 patients had an iatrogenic inner ear injury. The authors concluded that there are a significant number of inner ear injuries in VS patients. They highlighted the importance of a postoperative CT to delineate any potential injuries. This study demonstrates the importance of careful surgical planning to avoid unintentional injuries to inner ear structures. While it has some limitations including the retrospective nature, it still offers a good insight into postoperative inner ear complication rates.

Inner Ear Breaches from Vestibular Schwannoma Surgery: Revisiting the Incidence of Otologic Injury from Retrosigmoid and Middle Cranial Fossa Approaches.
Ben-Shlomo N, Rahimi A, Abunimer A, et al.
OTOL NEUROTOL
2924;45(3):311–8.