open access

Vol 51, No 2 (2017)
Original research articles
Submitted: 2016-11-20
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Endoscopic assistance in retrosigmoid transmeatal approach to intracanalicular vestibular schwannomas – An alternative for middle fossa approach. Technical note

Grzegorz Turek, Carlos Cotúa, Rocio Evangelista Zamora, Marcos Tatagiba
DOI: 10.1016/j.pjnns.2016.12.005
·
Neurol Neurochir Pol 2017;51(2):111-115.

open access

Vol 51, No 2 (2017)
Original research articles
Submitted: 2016-11-20

Abstract

Background

Complete surgical removal of intracanalicular vestibular schwannomas with nerve VII and VIII sparing and without worsening patient's status is challenging. Also the choice of an optimal surgical technique, which is usually limited to selection between retrosigmoid transmeatal (RT) and middle fossa (MF) approach, can be a challenge. Although many previous studies documented superiority of RT to MF approach and vice versa, still no consensus has been reached regarding an optimal approach to intracanalicular vestibular schwannomas. In this technical note, we present RT approach with an endoscopic assistance and highlight its advantages over MF approach in surgical management of pure intracanalicular vestibular schwannomas.

Method

RT approach with an endoscopic assistance is presented as an optimal surgical treatment for intracanalicular vestibular schwannomas, and its advantages are compared to those offered by MF approach.

Results

Under an endoscopic guidance, we found a residual tumor in the fundus of the inner acoustic canal and performed its gross total resection.

Conclusions

RT approach is an excellent technique suitable for safe radical surgical treatment of T1 vestibular schwannomas; this technique is associated with lower morbidity risk than MF approach.

Abstract

Background

Complete surgical removal of intracanalicular vestibular schwannomas with nerve VII and VIII sparing and without worsening patient's status is challenging. Also the choice of an optimal surgical technique, which is usually limited to selection between retrosigmoid transmeatal (RT) and middle fossa (MF) approach, can be a challenge. Although many previous studies documented superiority of RT to MF approach and vice versa, still no consensus has been reached regarding an optimal approach to intracanalicular vestibular schwannomas. In this technical note, we present RT approach with an endoscopic assistance and highlight its advantages over MF approach in surgical management of pure intracanalicular vestibular schwannomas.

Method

RT approach with an endoscopic assistance is presented as an optimal surgical treatment for intracanalicular vestibular schwannomas, and its advantages are compared to those offered by MF approach.

Results

Under an endoscopic guidance, we found a residual tumor in the fundus of the inner acoustic canal and performed its gross total resection.

Conclusions

RT approach is an excellent technique suitable for safe radical surgical treatment of T1 vestibular schwannomas; this technique is associated with lower morbidity risk than MF approach.

Get Citation

Keywords

Vestibular schwannoma, Intrameatal vestibular schwannoma, Retrosigmoid approach, Middle fossa approach, Endoscopic assistance

About this article
Title

Endoscopic assistance in retrosigmoid transmeatal approach to intracanalicular vestibular schwannomas – An alternative for middle fossa approach. Technical note

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 51, No 2 (2017)

Pages

111-115

DOI

10.1016/j.pjnns.2016.12.005

Bibliographic record

Neurol Neurochir Pol 2017;51(2):111-115.

Keywords

Vestibular schwannoma
Intrameatal vestibular schwannoma
Retrosigmoid approach
Middle fossa approach
Endoscopic assistance

Authors

Grzegorz Turek
Carlos Cotúa
Rocio Evangelista Zamora
Marcos Tatagiba

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