Application of modified enlarged translabyrinthine approach in the removal of vestibular schwannoma
10.3760/cma.j.issn.1673-0860.2014.03.005
- VernacularTitle:改良扩大迷路径路在听神经瘤手术中的应用
- Author:
Zhengjie ZHU
1
;
Zhaoyan WANG
;
Zhihua ZHANG
;
Qi HUANG
;
Jun YANG
;
Hao WU
Author Information
1. 200092,上海交通大学医学院附属新华医院耳鼻咽喉头颈外科 上海交通大学医学院耳科学研究所
- Keywords:
Neuroma,acoustic;
Otologic surgical procedures;
Postoperative complications;
Cerebrospinal fluid Otorrhea;
Facial nerve
- From:
Chinese Journal of Otorhinolaryngology Head and Neck Surgery
2014;49(3):196-199
- CountryChina
- Language:Chinese
-
Abstract:
Objective To describe and analyze the surgical outcomes of modified enlarged translabyrinthine approach (ETLA),which is combined with middle ear eradication and blind sac technique.Methods A retrospective study was conducted on 28 patients who underwent surgery for vestibular schwannoma (VS) via modified ETLA from Jan.2001 to Dec.2012.The sizes of tumors were 25-52 mn[(38.2-± 9.1)mm (x-± s)].Main outcomes measures included the rate of total removal,the rate of cerebral spinal fluid (CSF) leakage after surgery,complications,and intraoperative anatomical preservation of facial nerve and facial nerve function.Results Among the 28 patients who underwent modified ETLA,the rate of total removal was 100％.There was no death after surgery via modified ETLA.The rate of CSF leakage after surgery was 3.5％ (1/28).The rate of intraoperative anatomical preservation of facial nerve was 89.3％ (25/28).Short-term and long-term good facial nerve function rates were 25.0％ (7/28) and 42.9％ (12/28),respectively.Conclusions Modified ETLA is suitable for VS ＞ 3 cm with extension to the anterior region of cerebellopontine angle,VS involve with labyrinth part of facial nerve,high jugular bulb,preposing sigmoid sinus and highly pneumatized temporal bone.This approach can provide a wide surgical field and well prevention of CSF leakage.
