====== Vestibular schwannoma surgery complications ======

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Despite improvements in microsurgical technique and the use of [[intraoperative electrophysiological monitoring]], the potential for facial and [[cochlear nerve]] injury remains a possibility in the resection of [[vestibular schwannoma]]s (VS). 


[[Vestibular schwannoma surgery]] [[complications]] vary as expected by treatment modality, with [[cerebrospinal fluid leak]], [[tinnitus]], and trigeminal symptoms being among the most common complications following microsurgery
((Sarmiento JM, Patel S, Mukherjee D, Patil CG. Improving outcomes in patients
with vestibular schwannomas: microsurgery versus radiosurgery. J Neurosurg Sci.
2013 Mar;57(1):23-44. Review. PubMed PMID: 23584218.
)).



===== Facial nerve palsy =====

see [[Facial nerve palsy after vestibular schwannoma surgery]].

===== Trigeminal nerve dysfunction ===== 

In 333 patients after [[microsurgery]] ([[Koos grading scale]] 1: 12, grade 2: 34, grade 3: 62, and grade 4: 225) permanent [[trigeminal nerve]] dysfunction was found in 1%
((Betka J, Zvěřina E, Balogová Z, Profant O, Skřivan J, Kraus J, Lisý J, Syka J,
Chovanec M. Complications of microsurgery of vestibular schwannoma. Biomed Res
Int. 2014;2014:315952. doi: 10.1155/2014/315952. Epub 2014 May 28. PubMed PMID:
24987677; PubMed Central PMCID: PMC4058457.)).


In large/compressive, trigeminal nerve deficit has to be sought to avoid [[cornea]]l complications in particular. Trigeminal [[hypoesthesia]] occurs preoperatively in about half of the cases. It remains relatively stable after tumor removal, but there appears to be an increased rate of absent [[corneal reflex]] and [[neurotrophic keratitis]] postoperatively. Karkas et al. were able to correlate pre/postoperative trigeminal hypoesthesia with pre/postoperative [[MRI]] findings
((Karkas A, Lamblin E, Meyer M, Gay E, Ternier J, Schmerber S. Trigeminal nerve 
deficit in large and compressive acoustic neuromas and its correlation with MRI
findings. Otolaryngol Head Neck Surg. 2014 Oct;151(4):675-80. doi:
10.1177/0194599814545440. Epub 2014 Aug 1. PubMed PMID: 25085321.)).

===== Headache =====

see [[Postoperative headache after vestibular schwannoma surgery]].






===== Vascular complications =====
see [[Vestibular schwannoma surgery vascular complications]].

===== Cerebrospinal fluid fistula =====
[[Cerebrospinal fluid fistula after vestibular schwannoma surgery]].

===== Hearing loss =====

see [[Hearing Preservation in Vestibular Schwannoma]]


===== Neuropsychiatric disorders =====

[[Neuropsychiatric disorders after vestibular schwannoma surgery]]