Vascular complications of vestibular schwannoma surgery: a comparison of the suboccipital retrosigmoid and translabyrinthine approaches
Bibliographic record
Abstract
OBJECT: Vascular complications of the surgery for vestibular schwannomas (VSs) can have devastating consequences; however, there is scant literature on the systematic analysis of the different types of complications. In this context, the authors of this study analyzed these complications, with particular interest in the role of surgical approach in their occurrence. METHODS: The charts of 391 patients who had undergone 413 procedures for VS during a 24-year period were reviewed retrospectively. A suboccipital retrosigmoid (RS) approach was used in 338 procedures, and the translabyrinthine (TL) route in 75. Postoperative hemorrhage or infarction was identified and stratified according to the complication type and surgical approach. Postoperative vascular complications were encountered in 11 procedures (2.7%), and their incidence was the same for both the RS and TL approaches. Of these complications, eight were hemorrhagic (two cerebellopontine angle, one intracerebellar, and five epidural hematomas) and three were ischemic in nature. Five patients (45.4%) had a complete recovery, and four patients (36.4%) a partial recovery; two patients (18.2%) died. The overall procedure-related mortality rate was 0.5% (two of 413 procedures): 0.3% (one of 338 procedures) for the RS approach and 1.3% (one of 75 procedures) for the TL approach (p > 0.05). CONCLUSIONS: In this study, the overall incidences of vascular complications in VS surgery were similar for the RS and TL approaches. Regardless of the preferred surgical route, this group of complications carries a significant risk of morbidity and therefore warrants special consideration in the management of VSs.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".