Surgical Results and Technical Refinements in Translabyrinthine Excision of Vestibular Schwannomas

• DOI: 10.1227/neu.0b013e31824c010f
• Publication Date: 2012-01-21T12:08:48Z
• Authors: Mehdi Ben Ammar; Enrico Piccirillo; Vedat Topsakal; Abdelkader Taibah; Mario Sanna
• Keywords: Translabyrinthine approach; Acoustic neuroma

BACKGROUND: Vestibular schwannomas (VSs) are the most common cerebellopontine angle tumors, accounting for 75% of all lesions in this location. OBJECTIVE: To evaluate results after removal VS through enlarged translabyrinthine approach, which is a widening classic approach that gives larger access and provides more room to facilitate tumor minimize surgery-related morbidities. METHODS: This was retrospective study 1865 patients who underwent excision between 1987 2009. Mean age 50.39 years. size 1.8 cm. Median follow-up 5.7 RESULTS: Total achieved 92.33% cases; 143 had incomplete resection with evidence regrowth 8. In 1742 previously untreated patients, anatomic preservation facial nerve 1661 cases (95.35%), House-Brackmann grade I or II reached 1047 (59.87%). Facial outcome significantly better tumors ≤ 20 mm. Surgical complications included cerebrospinal fluid leakage 0.85%, meningitis 0.10%, intracranial bleeding 0.80%, non--VII/VIII cranial palsy 0.96%, cerebellar ataxia 0.69%, death 0.10%. The technical modifications evolved increasing experience described. CONCLUSION: safe effective VS. our experience, complication rate very low still main factor influencing postoperative function cutoff point at around ABBREVIATIONS: CPA, ETLA, FN, HB, IAC, internal auditory canal TLA, VS, vestibular schwannoma