ORIGINAL RESEARCH article
Front. Oncol.
Sec. Neuro-Oncology and Neurosurgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1589941
This article is part of the Research TopicAdvancing Multidisciplinary Approaches in Skull-Base Tumor ManagementView all 9 articles
Characteristics and Prognostic Analysis of Cystic Vestibular Schwannomas: Prolonged Surgical Duration with Limited Impact on Neurological Function
Provisionally accepted
- 1Qujing First People's Hospital, Qujing, China
- 2The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
- 3Southwest Forestry University, Kunming, Yunnan Province, China
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This study investigates the differences in imaging characteristics, surgical duration, gross total resection (GTR) rates, and postoperative neurological functional outcomes between cystic vestibular schwannomas (CVS) and solid vestibular schwannomas (SVS). A retrospective analysis of 273 patients revealed that CVS had larger tumor volumes, longer surgical durations (96.6 minutes vs. 87.5 minutes), and lower postoperative facial nerve function and hearing preservation rates, although no significant difference was observed in GTR rates. Multivariate analysis identified tumor volume and patient age as independent predictors of postoperative functional outcomes, while cystic changes had a limited impact on prognosis. The study highlights the importance of comprehensive preoperative evaluation of cystic changes and tumor volume to optimize individualized surgical strategies and perioperative management. when Gross total tumor resection (GTR) is pursued. [2][3][4][5] Therefore, the 2003 Vestibular Schwannoma Consensus Meeting recommended analyzing and reporting CVSs as a distinct subgroup of VSs. 6 However, recent studies have presented differing perspectives. A 2012 systematic review indicated no significant differences between CVSs and SVSs regarding the extent of resection, surgical complications, and mortality, except for poorer facial nerve outcomes in CVSs. 7 Furthermore, a 2024 multi-institutional cohort study suggested that the poorer facial nerve outcomes and lower GTR rates in CVSs patients might primarily result from larger tumor volumes rather than the presence of cystic components per se. 8 These findings challenge previous surgical strategies for CVSs, which prioritized subtotal resection (STR) to preserve cranial nerve function 9 , as patients undergoing STR undoubtedly experience higher tumor recurrence rates compared to those receiving GTR. 10 Recent improvements in surgical philosophy and intraoperative electrophysiological techniques have likely contributed to changes in CVSs surgical outcomes, enhancing neurovascular prognoses. Therefore, it is necessary to retrospectively analyze clinical characteristics of VSs treated surgically in recent years, comparing differences between CVSs and SVSs. Beyond previously emphasized outcome indicators, it is essential to consider additional objective metrics, such as tumor resection duration, GTR rates, and imaging characteristics.
Keywords: Cystic vestibular schwannomas, Solid vestibular schwannomas, Tumor resection duration, neurological outcomes, Tumor volume
Received: 08 Mar 2025; Accepted: 15 Jul 2025.
Copyright: © 2025 Lv, Li, Cai, Gong and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jibo Lv, Qujing First People's Hospital, Qujing, China
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