Application of modified enlarged translabyrinthine approach in the removal of vestibular schwannoma.

Zhengjie Zhu; Zhaoyan Wang; Zhihua Zhang; Qi Huang; Jun Yang; Hao WU

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Application of modified enlarged translabyrinthine approach in the removal of vestibular schwannoma.

Author: Zhengjie ZHU ¹ ; Zhaoyan WANG ¹ ; Zhihua ZHANG ¹ ; Qi HUANG ¹ ; Jun YANG ¹ ; Hao WU ²
Author Information

1. Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Jiaotong University Ear Institute, Shanghai 200092, China.
2. Department of Otorhinolaryngology Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai Jiaotong University Ear Institute, Shanghai 200092, China. Email:ent.haowu@gmail.com.
Publication Type:Journal Article
MeSH: Adolescent; Adult; Cerebrospinal Fluid Otorrhea; prevention & control; Ear, Inner; surgery; Female; Humans; Male; Middle Aged; Neuroma, Acoustic; surgery; Otologic Surgical Procedures; methods; Retrospective Studies; Young Adult
From: Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2014;49(3):196-199
CountryChina
Language:Chinese
Abstract:
OBJECTIVETo describe and analyze the surgical outcomes of modified enlarged translabyrinthine approach(ETLA), which is combined with middle ear eradication and blind sac technique.
METHODSA 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 mm[(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.
RESULTSAmong 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.
CONCLUSIONSModified 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, proposing sigmoid sinus and highly pneumatized temporal bone. This approach can provide a wide surgical field and well prevention of CSF leakage.