The learning curve for acoustic tumor surgery

Although operative experience is considered to be critically important in the surgical management of acoustic tumors, little objective evidence substantiates this claim. The present study was undertaken to determine whether a learning curve exists for acoustic tumor surgery. The first 96 acoustic tumor patients managed surgically by a new neurotologic team were retrospectively reviewed. A significant improvement (P<.0003; F=6.32) in the ability to achieve good (grade II or better) postoperative facial nerve function was identified. Improving trends for complete resection rate and hearing preservation were documented, and the incidence of cerebrospinal fluid (CSF) leaks declined; however, statistical significance was not achieved. For postoperative facial nerve function, approximately 60 cases were necessary before the new team achieved results similar to those of highly experienced surgeons. The frequencies of complete resection, CSF leaks, hearing preservation, stroke, and mortality were comparable to those of experienced neurotologic teams. The findings of this study may have implications for both patient care and physician training.