Flexible Endoscopic-Assisted Microsurgical Radical Resection of Intracanalicular Vestibular Schwannomas by a Retrosigmoid Approach: Operative Technique

The efficacy of endoscopic techniques in the surgical management of intracanalicular vestibular schwannomas (ICVSs) has been underlined in recent studies. An endoscopic- assisted retrosigmoid approach (EARSA) appears to be particularly suitable for achieving complete resection of an ICVS. In this st...

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Bibliographic Details
Published in:World neurosurgery 2018-07, Vol.115, p.229-233
Main Authors: Corrivetti, Francesco, Cacciotti, Guglielmo, Giacobbo Scavo, Carlo, Roperto, Raffaelino, Mastronardi, Luciano
Format: Article
Language:English
Subjects:
Endoscopic-assisted retrosigmoid approach
Endoscopy
Flexible endoscope
Intracanalicular vestibular schwannoma
Vestibular schwannoma
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Summary:The efficacy of endoscopic techniques in the surgical management of intracanalicular vestibular schwannomas (ICVSs) has been underlined in recent studies. An endoscopic- assisted retrosigmoid approach (EARSA) appears to be particularly suitable for achieving complete resection of an ICVS. In this study, we describe the surgical treatment of 3 cases of ICVS with an EARSA, highlighting the advantages and limitations of flexible endoscopy in accomplishing a safe radical resection with hearing preservation. Three patients with an ICVS underwent surgery via a flexible endoscopic-assisted microneurosurgical retrosigmoid approach. Flexible endoscopic assistance allowed the identification of residual tumor located in the most lateral portion of the fundus of the internal auditory canal in all cases. Endoscopic controls and further microsurgical resection were attempted, and complete surgical resection was achieved in all cases without the occurrence of postoperative facial or auditory nerve dysfunction. Flexible endoscopy appears to be particularly useful and safe in the surgical management of ICVS by microneurosurgery via an EARSA. •Endoscopic-assisted techniques in the surgical treatment of cerebellopontine angle tumors are well known.•We focused on the endoscopic utilisation in the surgical treatment of intracanalicular vestibular schwannomas.•Advantages and limitations of flexible endoscopic assistance are discussed.•In our experience, this is the first case series on this topic.
ISSN:1878-8750
1878-8769
DOI:10.1016/j.wneu.2018.04.108