Otol Neurotol. 2021 Jun 25. doi: 10.1097/MAO.0000000000003251. Online ahead of print.
ABSTRACT
OBJECTIVE: To assess outcomes after surgery for vestibular schwannoma in patients over 70 years of age.
STUDY DESIGN: Retrospective chart review.
SETTING: Two tertiary otology and neurotology centers.
PATIENTS AND INTERVENTIONS: Patients undergoing primary surgery for vestibular schwannoma between 2007 and 2018.
MAIN OUTCOME MEASURES: Postoperative complications and surgical outcomes.
RESULTS: A total of 452 patients met inclusion criteria, 31 of whom (6.9%) were over 70 years of age. Age ranged from 18 to 90 years with a mean of 53 years. Elderly patients were more likely to have pre-existing hypertension (58.1% versus 34.0%, p = 0.007) and diabetes mellitus (19.4% versus 7.4%, p = 0.02). Elderly patients were less likely to undergo gross total resections of their tumors (35.5% versus 60.6%, p = 0.05) although they were not statistically significantly more likely to undergo subtotal (<95%) resections (25.8% versus 14.7%, p > 0.05). Elderly patients were also less likely to undergo second stage procedures (0% versus 9.5%, p = 0.04). There were no significant differences between elderly and non-elderly patients in the rates of any complications, ultimate facial nerve function, or duration of surgery. No patients over 70 years of age expired within 1 year of surgery.
CONCLUSIONS: Conservative surgery for vestibular schwannoma in appropriately selected elderly patients is appropriate and safe, given adequate consideration to risk-benefit analysis and goals of care.
PMID:34172668 | DOI:10.1097/MAO.0000000000003251
