Total Endoscopic Transcanal Transpromontorial Approach for Vestibular Schwannoma Resection: A Case Series & Outcome Analysis

By June 7, 2019

Cha, Dongchul 1;Lee, Se A.1 ; Nam, Sung Il2; Moon, In Seok1
1 Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Koea;
2 Department of Otorhinolaryngology, Keimyung University College of Medicine, Daegu, South Korea.

To demonstrate successful surgical management of small vestibular schwannomas via an exclusively endoscopic transcanal transpromontorial approach (EETTA) with little modification which do not close external auditory canal.

– Study Design: Retrospectove case review
– Setting: tertiary referral center
– Patients : Between June 2016 and January 2019, 12 patients with small vestibular schwannoma underwent surgery using a modified EETTA.
– Interventions: Therapeutic

– Main Outcome measures: Technique refinements, Treatment outcomes, including efficacy of tumor resection, preservation of function, operation time, and quality of life (QOL), were evaluated.
– Results: Nine tumors were Koos grade I and three tumors were Koos grade II. All ears had non-serviceable hearing prior to surgery. The modified EETTA enabled access to the internal auditory canal and porus acousticus as well as limited access to the cerebellopontine angle. Gross total resection was accomplished in all cases. There were no major complications, and all patients exhibited normal facial nerve function immediately after surgery. The mean follow-up period was 13.2 months. The operation time (average 188.5 ± 59.8 minutes) and hospitalization period (average 6.1 ± 1.0 days) were favorable. Short Form-36 scores for QOL showed unremarkable results compared with the results from translabyrinthine approaches.
– Conclusions: The modifie EETTA can be successfully used for the management of small vestibular schwannomas in ears without serviceable hearing. It can be an alternative surgical option in near future.