Zhang Binghan, Geng Haoming, Tang Yuanchen, Liu Dong, Wu Xiaolong, Lan Tian, Zhou Yiqiang, Wang Xu, Song Gang, Liang Jiantao
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
International Neuroscience Institute (China-INI), Beijing, China.
Neurosurg Rev. 2025 Aug 27;48(1):621. doi: 10.1007/s10143-025-03776-8.
This study aims to evaluate the surgical outcomes and clinical differences of elderly vestibular schwannoma (VS) patients (> 65 years), compared with non-elderly patients, focusing on baseline characteristics, preoperative symptoms, postoperative facial and auditory functions, and quality of life. A retrospective study was conducted on 59 elderly and 59 non-elderly patients, matched 1:1 by tumor size. All patients underwent retro-sigmoid microsurgery performed by the same neurosurgical team during the period from December 2018 to September 2023. Data including demographics, imaging findings, clinical symptoms, hearing, facial nerve function, and surgical outcomes were collected. Regular follow-up was conducted to assess postoperative recovery. Elderly patients had a longer disease course (median: 36 months) and a higher proportion with poor preoperative ASA scores (P < 0.001). Hearing loss was the most common symptom in the elderly group (n = 47, 79.7%), who were also more likely to have hydrocephalus (15.3%, P = 0.027) and balance disorder (25.4%, P = 0.006). Gross total resection rates were significantly lower in elderly patients (55.9% vs. 78.0%, P = 0.011). Postoperative and follow-up facial nerve function showed no statistical difference between groups, but hearing preservation was poor in both. Compared to non-elderly patients, elderly patients had longer disease courses, more preoperative symptoms, and slower postoperative recovery. Despite poorer general conditions and more comorbidities, advanced age should not be a contraindication for surgery, as long-term outcomes are favorable when individualized patient factors are considered.
本研究旨在评估老年（>65岁）前庭神经鞘瘤（VS）患者与非老年患者相比的手术结果和临床差异，重点关注基线特征、术前症状、术后面部和听觉功能以及生活质量。对59例老年患者和59例非老年患者进行了一项回顾性研究，根据肿瘤大小1:1配对。2018年12月至2023年9月期间，所有患者均由同一神经外科团队进行乙状窦后显微手术。收集了包括人口统计学、影像学检查结果、临床症状、听力、面神经功能和手术结果等数据。进行定期随访以评估术后恢复情况。老年患者病程较长（中位数：36个月），术前ASA评分较差的比例较高（P<0.001）。听力损失是老年组最常见的症状（n=47，79.
