Management of treatment small vestibular schwannomas using microscopic with endoscopic surgery: a single center experience

Objective The aim of this study was to retrospectively analyze the clinical data of 24 patients with small vestibular schwannomas, explore the surgical outcomes, and summarize the surgical experience. Methods Patients with small vestibular schwannomas who underwent surgery between January 2019 and December 2022 at the Department of Neurosurgery of the First Affiliated Hospital of Soochow University were included. Clinical data from all patients were collected and analyzed. Results Total tumor resection was achieved in all patients. Microscopic surgery alone was sufficient for complete resection in 17 patients, while the remaining 7 patients required combined microscopic and endoscopic approaches for complete removal. At the final follow-up, 22 patients demonstrated HB grade II or better facial nerve function. One patient maintained preoperative facial nerve function, while one patient experienced deterioration. During the follow-up period, all patients showed favorable prognosis without disease progression. Conclusions Surgical resection should be considered as the first-line treatment for patients with small vestibular schwannomas who are surgical candidates.