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Erschienen in:
20.03.2018 | Otology
Intralabyrinthine schwannomas: a new surgical treatment
Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 5/2018
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Objective
To define a new surgical option, with lower morbidity, for the treatment of intralabyrinthine schwannomas.
Study design
Retrospective case review.
Setting
Tertiary referral centers.
Patients
Eight patients affected by an intralabyrinthine schwannoma, with or without extension to the internal auditory canal, that underwent surgery with a transcanal transpromontorial approach, were included in the study. The average age at presentation was 47 years. Patients’ characteristics, symptoms, tumor features, and surgical results were analyzed.
Interventions
All patients were diagnosed and evaluated pre-operatively with high-resolution, gadolinium-enhanced MRI and CT scan of the temporal bone, and underwent surgery via either transcanal transpromontorial endoscopic approach (TTEA) or enlarged transcanal transpromontorial endoscopic approach (ETTA).
Main outcome measures
Hearing function was evaluated with the Hearing Classification System according to the Committee on Hearing and Equilibrium Guidelines. Facial nerve function was evaluated using the House–Brackmann grading system (HB).
Results
In six patients out of eight, a TTEA was performed, whereas, due to the extension of the pathology to the cerebellopontine angle, two patients underwent an ETTA. The mean follow-up period was 15.5 months (range 1–69). No intra-operative and post-operative major complications were observed. Post-operative facial nerve function was normal in seven out of eight patients (grade I HB). One patient presented a grade II HB.
Conclusion
The endoscopic approach to cochlear schwannoma represents a good treatment option for patients and should be preferred to other more invasive surgical techniques when indicated, to reduce complications, hospitalization, and offer to patients the chance to eradicate the disease, thus avoiding the stress of a long-life radiological follow-up.
Level of evidence
4.