morbidity and mortality with AN

[bfoley]

Happened across this 2011 paper

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3199160/

In the Discussion area of the paper:

"Perhaps the most striking and correctable finding is the persistence of the impact of surgeon caseload in independently predicting outcome following acoustic neuroma excision. Whether the outcome measure was mortality, morbidity, or adverse discharge disposition, surgeons performing fewer than 3 acoustic neuroma excisions per year yielded significantly inferior patient outcomes than surgeons performing 3 or more acoustic neuroma excisions per year (Tables 4–6). These findings persisted even after markers of advanced disease were accounted for (Tables 7 and ​and ,8), and provide ample evidence that optimal surgical care of acoustic neuroma patients requires a surgeon performing on average at least 1 acoustic neuroma excision every 4 months. It is perhaps fortunate that over the 10-year period of this analysis, more than two-thirds of patients received care from a high-caseload surgeon, otherwise the morbidity/mortality findings may have proved of more concern. The finding regarding surgeon caseload is consistent with previous literature; however, our finding that hospital caseload did not predict outcome differs from previous literature."

Interesting and food for thought!!

[donjehle]

It is an old, but fascinating study.  We try to encourage the readers of these forums to seek specialists with plenty of experience in treating acoustic neuromas.

Another part I found interesting was in their conclusion:

"Although overall morbidity and adverse discharge disposition were similar regardless of race, African Americans were 9 times more likely to die following surgery than Caucasian patients over a decade-long analysis. Given the relatively benign natural history of acoustic neuroma and the alarmingly increased mortality rate following surgical excision among older patients, African Americans, and patients receiving care from low-caseload surgeons, acoustic neuromas in these patient populations may be best managed by more minimally invasive modalities such as observation, fractionated stereotactic radiotherapy, and stereotactic radiosurgery."