Affiliation:
1. Departments of Neurosurgery and
2. Huntington Medical Research Institutes, Pasadena; and
3. Neurotology, House Clinic, Los Angeles;
4. Department of Otolaryngology, University of Southern California, Los Angeles, California
Abstract
OBJECTIVETranslabyrinthine resection is one of a number of treatment options available to patients with vestibular schwannomas. Though this procedure is hearing destructive, the authors have noted excellent clinical outcomes for patients with small tumors. The authors review their experience at a tertiary acoustic neuroma referral center in using the translabyrinthine approach to resect small vestibular schwannomas. All operations were performed by a surgical team consisting of a single neurosurgeon and 1 of 7 neurotologists.METHODSData from a prospectively maintained clinical database were extracted and reviewed. Consecutive patients with a preoperative diagnosis of vestibular schwannoma that had less than 1 cm of extension into the cerebellopontine angle, operated on between 2008 and 2013, were included. Patents with neurofibromatosis Type 2, previous treatment, or preexisting facial weakness were excluded. In total, 107 patients were identified, 74.7% of whom had poor hearing preoperatively.RESULTSPathologically, 6.5% of patients were found to have a tumor other than vestibular schwannoma. Excluding two malignancies, the tumor control rates were 98.7%, as defined by absence of radiographic disease, and 99.0%, as defined by no need for additional treatment. Facial nerve outcome was normal (House-Brackmann Grade I) in 97.2% of patients and good (House-Brackmann Grade I–II) in 99.1%. Complications were cerebrospinal fluid leak (4.7%) and sigmoid sinus thrombosis (0.9%), none of which led to long-term sequelae.CONCLUSIONSTranslabyrinthine resection of small vestibular schwannomas provides excellent results in terms of complication avoidance, tumor control, and facial nerve outcomes. This is a hearing-destructive operation that is advocated for selected patients.
Publisher
Journal of Neurosurgery Publishing Group (JNSPG)
Subject
Genetics,Animal Science and Zoology
Reference118 articles.
1. Hearing handicap, rather than measured hearing impairment, predicts poorer quality of life over 10 years in older adults;Gopinath;Maturitas,2012
2. Long-term outcomes after radiosurgery for acoustic neuromas;Kondziolka;N Engl J Med,1998
3. Prevention of headache after retrosigmoid removal of acoustic tumors;Catalano;Am J Otol,1996
4. Radiation therapy for the treatment of vestibular schwannoma: a critical evaluation of the state of the literature;Bassim;Otol Neurotol,2010
5. Ein gliom des akustikus;Panse;Arch Ohrenheilk,1904
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