An electrophysiological study on the safety of the endoscope-assisted microsurgical removal of vestibular schwannomas

Abstract

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Surgical exposure of the internal auditory canal through the retrosigmoid approach with semicircular canals anatomical preservation

“…Drilling of the IAC was performed with aid of CT based navigation images and the lateral portion of the IAC was opened with endoscope. It was observed that the use of endoscopy and navigation through RSA approach maximized the exposure of the IAC-fundus without injury to the labyrinth 21,30 .…”

“…Recent studies have shown the use of endoscopy and navigation in VS surgery through the RSA to preserve labyrinth integrity 21,30 . Drilling of the IAC was performed with aid of CT based navigation images and the lateral portion of the IAC was opened with endoscope.…”

Minimally Invasive Endoscopic and Endoscopy-Assisted Microsurgery of Vestibular Schwannoma

“…Similarly endoscopes are used for visualization of the drilled-out portion of the petrous bone for opened air cells that might need sealing. Some authors report that the risk of cerebrospinal fluid leaks have been lowered or even completely avoided (Valtonen et al 1997, Wackym et al 2002, Gerganov et al 2010. Under specific anatomical conditions angled endoscopes can be beneficial to identify and manage high jugular bulb (Betka et al 2010).…”

“…Thus it is mandatory to achieve synchronized, in-and-out movements of the endoscope together with the instruments (Jarrahy et al 2002a, Jarrahy et al 2002b, Kabil & Shahinian, 2006, de Vitiis et al 2007). Using the video-endoscopy assisted microsurgical technique the handling of instruments is controlled by the microscope befor e comin g in fr on t of t h e len s of t h e endoscope , Miyazaki et al 2005, Betka et al 2010, Gerganov et al 2010. Another potential risk of the endoscopic technique is possibility of heat injury from prolonged use of the endoscope too close to the cranial nerves and other brain structures (Betka et al 2010, Gerganov et al 2010).…”

“…Using the video-endoscopy assisted microsurgical technique the handling of instruments is controlled by the microscope befor e comin g in fr on t of t h e len s of t h e endoscope , Miyazaki et al 2005, Betka et al 2010, Gerganov et al 2010. Another potential risk of the endoscopic technique is possibility of heat injury from prolonged use of the endoscope too close to the cranial nerves and other brain structures (Betka et al 2010, Gerganov et al 2010). Thus it is of the utmost importance to irrigate the operating field regularly, because the tip of the endoscope may become very hot (Wackym et al 2002, Goksu e al.…”