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Endoscopic assistance in retrosigmoid transmeatal approach to intracanalicular vestibular schwannomas – An alternative for middle fossa approach. Technical note
Affiliations- Department of Neurosurgery, Eberhard-Karls-University of Tübingen, Tübingen, Germany
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Abstract
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.
MethodRT 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.
ResultsUnder an endoscopic guidance, we found a residual tumor in the fundus of the inner acoustic canal and performed its gross total resection.
ConclusionsRT 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
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.
MethodRT 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.
ResultsUnder an endoscopic guidance, we found a residual tumor in the fundus of the inner acoustic canal and performed its gross total resection.
ConclusionsRT 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.
Keywords
Vestibular schwannoma, Intrameatal vestibular schwannoma, Retrosigmoid approach, Middle fossa approach, Endoscopic assistance
About this articleTitle
Endoscopic assistance in retrosigmoid transmeatal approach to intracanalicular vestibular schwannomas – An alternative for middle fossa approach. Technical note
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
111-115
Page views
376
Article views/downloads
794
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
