Early surgery and definitive cure in small sporadic vestibular schwannoma

Objective. To report surgical outcomes of a cohort of small sporadic vestibular schwan-noma and discuss the role of early surgery. Methods. Retrospective descriptive analysis of 234 consecutive patients with small ves-tibular schwannoma operated on with translabyrinthine or hearing preservation surgical ap-proaches. Outcome measures were control of disease, postoperative facial nerve function, complications and hearing outcome. Results. A translabyrinthine approach was performed in 59% of cases, hearing preservation surgery in 40% and transmeatal approach in 1%, respectively. Complete resection was achieved in 100% of cases. Overall, postoperative major and minor complications were 8.5% in the series, with complete recovery and no sequalae. Facial nerve function at one year postoperatively was House-Brackmann scale (HB) 1-2 in 95% of cases. The rate of hearing preservation was 70% A-B-C classes of Tokyo classification and 77% AB classes of AAOHNS classification. Conclusions. Early surgery in small vestibular schwannoma is a valid option, due to good functional outcomes, low morbidity and definitive cure. Early surgery is associated with better outcomes when considered in relation to non-surgical treatments reported in the lit-erature.