Hearing Preservation Using the Middle Fossa Approach for the Treatment of Vestibular Schwannoma

Kutz, Joe Walter; Scoresby, Tyler; Isaacson, Brandon; Mickey, Bruce; Madden, Christopher J.; Barnett, Samuel L.; Coimbra, Caetano; Hynan, Linda S.; Roland, Peter S.

doi:10.1227/neu.0b013e31823110f1

Cited by 48 publications

(33 citation statements)

References 31 publications

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“…Although removal of medium or large ANs carries a considerable risk for facial palsy, 38 a series of recent studies of removal of small ANs reported high rates of facial function preservation (88%-100%) 9,13,16,18,21,23,24,27,36,37,42 (Table 3). In our study, the rate of normal facial function preservation (House-Brackmann Grade I) was 100%.…”

Section: Long-term Outcome Of Curative Small An Removal With Preservamentioning

confidence: 99%

Retrosigmoid removal of small acoustic neuroma: curative tumor removal with preservation of function

Yamakami

Ito

Higuchi

2014

JNS

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As a result of a surgical technique that involved sharp dissection and internal auditory canal reconstruction with intraoperative auditory monitoring, retrosigmoid removal of small ANs can lead to successful curative tumor removal without long-term recurrence and with excellent functional outcome. Thus, the authors suggest that tumor removal should be the first-line management strategy for younger patients with small ANs and preserved hearing.

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Section: Long-term Outcome Of Curative Small An Removal With Preservamentioning

confidence: 99%

Retrosigmoid removal of small acoustic neuroma: curative tumor removal with preservation of function

Yamakami

Ito

Higuchi

2014

JNS

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“…Prerequisites for the translabyrinthine approach include mainly the preoperative lack of serviceable hearing and the presence of larger tumors [9, 10]. The retrosigmoid (suboccipital) approach allows the removal of tumors of any size with the potential for hearing preservation; its main disadvantage is the need for cerebellar retraction [11, 12]. Lastly, the middle fossa approach is chosen for tumors limited to the internal auditory canal or with minimal CPA extension with an attempt to preserve hearing.…”

Section: Introductionmentioning

confidence: 99%

Complications of Microsurgery of Vestibular Schwannoma

Betka

Zvĕrina

Balogová

et al. 2014

BioMed Research International

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Background. The aim of this study was to analyze complications of vestibular schwannoma (VS) microsurgery. Material and Methods. A retrospective study was performed in 333 patients with unilateral vestibular schwannoma indicated for surgical treatment between January 1997 and December 2012. Postoperative complications were assessed immediately after VS surgery as well as during outpatient followup. Results. In all 333 patients microsurgical vestibular schwannoma (Koos grade 1: 12, grade 2: 34, grade 3: 62, and grade 4: 225) removal was performed. The main neurological complication was facial nerve dysfunction. The intermediate and poor function (HB III–VI) was observed in 124 cases (45%) immediately after surgery and in 104 cases (33%) on the last followup. We encountered disordered vestibular compensation in 13%, permanent trigeminal nerve dysfunction in 1%, and transient lower cranial nerves (IX–XI) deficit in 6%. Nonneurological complications included CSF leakage in 63% (lateral/medial variant: 99/1%), headache in 9%, and intracerebral hemorrhage in 5%. We did not encounter any case of meningitis. Conclusions. Our study demonstrates that despite the benefits of advanced high-tech equipment, refined microsurgical instruments, and highly developed neuroimaging technologies, there are still various and significant complications associated with vestibular schwannomas microsurgery.

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“…Our long-term facial nerve function is comparable with previous studies. 12,13,19 Of 49 subjects, Woodson et al 19 reported that 46 (96%) exhibited HB grade 1 and 3 subjects exhibited HB grade 2 with more than 2 years of follow-up. Of the 33 patients with a 5-year follow-up, 4 (12%) exhibited tumor recurrence on MRI, which is consistent with other studies.…”

Section: Discussionmentioning

confidence: 99%

Hearing Preservation after Middle Fossa Vestibular Schwannoma Removal

Quist

Givens

Gurgel

et al. 2015

Otolaryngol.--head neck surg.

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Hearing Preservation Using the Middle Fossa Approach for the Treatment of Vestibular Schwannoma

Abstract: Hearing preservation rates are excellent using the middle fossa approach, especially for smaller tumors. No patient experienced long-term facial nerve function worse than House-Brackmann grade III.

Cited by 48 publications

References 31 publications

Retrosigmoid removal of small acoustic neuroma: curative tumor removal with preservation of function

Retrosigmoid removal of small acoustic neuroma: curative tumor removal with preservation of function

Complications of Microsurgery of Vestibular Schwannoma

Hearing Preservation after Middle Fossa Vestibular Schwannoma Removal

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