Grading system and surgical approaches for endolymphatic sac tumors

Li, Feitian; Zhang, Yibo; Li, Wei; Wu, Qianru; Kong, Dedi; Shi, Xunbei; Dai, Chenyang

doi:10.1007/s00405-020-06185-3

Cited by 10 publications

(9 citation statements)

References 22 publications

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“…To date, complete surgical resection is still the first choice for the treatment of ELSTs. Most authors advocate that the choice of surgical approaches should depend on the patient’s preoperative hearing status, tumor location, and the relationship to the adjacent anatomic structures 16,17 . The common surgical choices used as a treatment for ELSTs include retrolabyrinthine posterior petrosectomy (RL), retrosigmoid (RS), transmastiod (TS), translabyrinthine (TL), subtemporal transpetrous, and infratemporal fossa (ITF) approaches 9,16,17 .…”

Section: Discussionmentioning

confidence: 99%

“…Reviewing the treatment experience of the patient, it can be seen that the surgeon chose the suboccipital approach during the initial operation, which could not provide a good visualization to observe the posterior semicircular canal area. 16,18 At the time of the second operation, the tumor had already caused partial damage to the labyrinth and cochlea (Fig. 3), so it was inappropriate to choose the STP approach, which may be the main factor leading to the tumor recurrence after the operation.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, ELSTs are prone to relapse after surgery. Even after complete tumor resection, the recurrence rate is still between 10% and 29.3%, 3,16,22 while for patients undergoing subtotal tumor resection, almost 100% of them will relapse after surgery. Therefore, long-term follow-up is mandatory for ELST patients, and it is recommended to conduct follow-up at least every 6 months.…”

Section: Discussionmentioning

confidence: 99%

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The Diagnosis and Management of Advanced Endolymphatic Sac Tumor

Zhang

Guo

et al. 2023

Journal of Craniofacial Surgery

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Endolymphatic sac tumor (ELST) is a group of low-grade malignant tumors originating from the endolymphatic sac of the inner ear. It is rare in the clinic and has the biological characteristics of slow growth and local aggression. Due to the lack of specificity in the clinical manifestations of patients with ELST, many cases have entered the advanced stage at the time of diagnosis. However, there are still great challenges in the treatment of advanced ELSTs. Here, the authors describe a case of advanced ELST, which relapsed after 2 operations. This time, the authors chose the transotic approach for tumor resection, which achieved the goal of complete resection of the tumor, and the patient recovered smoothly after surgery. There were no surgical complications and no tumor recurrence after the follow-up. Through literature review and our own experience, the authors suggest that complete surgical resection is the first choice for both primary and recurrent advanced ELSTs. The choice of a reasonable surgical approach is the key to ensuring complete resection of the tumor, while preoperative angiography and embolization, fine treatment of important structures during surgery, and postoperative long-term follow-up are equally important for patients with advanced ELST to obtain a good prognosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Diagnosis and Management of Advanced Endolymphatic Sac Tumor

Zhang

Guo

et al. 2023

Journal of Craniofacial Surgery

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“…The mainstay of therapy is a complete resection of the tumor via a translabyrinthine, retrosigmoid, or subtemporal approach, depending on tumor extension 282 . In cases of early resection, hearing preservation is often possible.…”

Section: Episodic Vestibular Syndromesmentioning

confidence: 99%

“…Die Therapie der Wahl ist eine komplette Resektion des Tumors, welche je nach Ausdehnung über einen translabyrinthären, retrolabyrinthären, retrosigmoidalen oder subtemporalen Zugang erfolgen kann 282 . Bei frühzeitiger Resektion besteht die Möglichkeit des Hörerhaltes.…”

Section: 423 Therapieunclassified

Seltene Erkrankungen des vestibulären Labyrinths: von Zebras, Chamäleons und Wölfen im Schafspelz

Dlugaiczyk

2021

Laryngorhinootologie

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ZusammenfassungDie Differenzialdiagnose von Erkrankungen des vestibulären Labyrinths stellt eine grosse Herausforderung dar, da sich hinter dem sehr häufigen Leitsymptom «Schwindel» viele verschiedene und v. a. seltene Erkrankungen verbergen können. Der vorliegende Beitrag gibt einen Überblick über die für den HNO-Arzt wichtigen seltenen Erkrankungen des vestibulären Labyrinths ausgehend von ihrer klinischen Präsentation als akutes (AVS), episodisches (EVS) oder chronisches vestibuläres Syndrom (CVS). Der Schwerpunkt liegt dabei auf den EVS, sortiert nach ihrer Dauer und dem Vorhandensein von Triggern (Sekunden, ohne Trigger: Vestibularisparoxysmie, Tumarkin-Krise; Sekunden, lärm- und druckinduziert: Syndrome des «dritten Fensters»; Sekunden bis Minuten, positionsabhängig: seltene Varianten und Differenzialdiagnosen des benignen paroxysmalen Lagerungsschwindels; Stunden bis Tage, spontan: intralabyrinthäre Schwannome, Tumoren des endolymphatischen Sacks, Autoimmunerkrankungen des Innenohres). Des Weiteren werden seltene Differenzialdiagnosen eines AVS (Neuritis vestibularis inf., Otolithenfunktionsstörungen, vaskuläre Ursachen, akute bilaterale Vestibulopathie) und eines CVS (bilaterale Vestibulopathie) erläutert. Dabei werden insbesondere die entscheidenden diagnostischen Massnahmen für die Identifikation der einzelnen Krankheitsbilder und die Warnzeichen für potentiell gefährliche Ursachen (z. B. Labyrinthinfarkt/-blutung) dargelegt. Somit dient dieser Beitrag dem HNO-Arzt in Klinik und Praxis als eine Art «Vademecum» für die zügige Identifikation und zeitnahe Therapie seltener Erkrankungen des Gleichgewichtsorgans.

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Surgical Outcomes in Patients with Endolymphatic Sac Tumors: A Single‐Center Experience of 29 Patients

Yang,

Li,

et al. 2024

The Laryngoscope

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ObjectiveTo analyze the clinical features and surgical outcomes of patients with endolymphatic sac tumors (ELSTs).Study DesignSingle institution retrospective cohort study.MethodsThe clinical data of 29 patients with 30 ELSTs who underwent surgery were retrospectively reviewed. Information on patient demographics, tumor size and grade, intraoperative blood loss volume, hearing and facial nerve outcomes, and follow‐up data was collected and analyzed.ResultsThe main symptoms were hearing loss in 26 ELSTs (86.7%) and tinnitus in 17 (56.7%). Twenty‐four (80%) ELSTs were in advanced stages (Grade III). The median tumor volume was 6.35 cm3. The median intraoperative blood loss volume was 300 mL. Facial nerve function was well preserved in 21 patients. Among all patients with Grade III tumors, 12 patients underwent tension‐free anterior facial nerve rerouting, and 11 patients (91.7%) maintained good facial nerve function postoperatively (HB I and HB II). Only one patient exhibited permanent vocal cord paralysis, and no patients experienced cerebrospinal fluid (CSF) leakage postoperatively. Gross total resection was achieved in 22 patients (73.3%), 5 patients (16.7%) experienced tumor recurrence, and 3 (10%) had residual tumors.ConclusionsMost ELSTs tend to be diagnosed in the advanced stage. Tension‐free anterior facial nerve rerouting could maximally preserve facial nerve function. The intraoperative blood loss volume was associated with tumor size and stage. Tumor recurrence tends to occur at the posterior edge of the petrosal bone, internal auditory canal, and surface of the posterior fossa. Given the relatively high recurrence rate of ELSTs, long‐term follow‐up is recommended.Level of Evidence4 Laryngoscope, 2024

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Grading system and surgical approaches for endolymphatic sac tumors

Cited by 10 publications

References 22 publications

The Diagnosis and Management of Advanced Endolymphatic Sac Tumor

The Diagnosis and Management of Advanced Endolymphatic Sac Tumor

Seltene Erkrankungen des vestibulären Labyrinths: von Zebras, Chamäleons und Wölfen im Schafspelz

Surgical Outcomes in Patients with Endolymphatic Sac Tumors: A Single‐Center Experience of 29 Patients

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