A comparative retrospective study assessing surgical, functional and radiological outcomes after retrosigmoid versus translabyrinthine resection of large vestibular schwannomas.

Erginoglu, Kendirlioglu, Korkmaz, Uyaniker, Baskaya and colleagues analyzed 283 Koos III–IV vestibular schwannomas. The study compared extent of resection, facial nerve outcome, hearing preservation potential and postoperative imaging findings between retrosigmoid and translabyrinthine approaches.

The translabyrinthine group achieved a higher rate of gross-total or near-total resection in this cohort, while favorable facial nerve outcomes at one year were similar between approaches. The retrosigmoid approach retained the possibility of hearing preservation. The authors also emphasize that tumor volume adds useful information beyond Koos grade when selecting a surgical strategy.

Why it matters

This study provides practical comparative data for one of the most common approach-selection decisions in lateral skull-base surgery. Its emphasis on tumor volume may improve preoperative planning and patient counseling beyond the conventional Koos classification alone.

Reference

Erginoglu U, Kendirlioglu BC, Korkmaz TS, Uyaniker ZA, Baskaya MK, et al.
Single-stage retrosigmoid versus translabyrinthine resection of vestibular schwannomas: impact of tumor volume on surgical, functional, and radiological outcomes.
Journal of Neurosurgery. 2026;145(4):1128–1140. Published online July 31, 2026.
DOI: 10.3171/2026.2.JNS252437
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