Еndoscopic possibilities of the acoustic schwannomas removal in internal auditory canal
Keywords:schwannomas, schwannomas spread into internal auditory canal, endoscopic removal of schwannomas
Aim. To investigate the features of schwannoma spread into internal auditory canal and methods for its removal.
Materials and methods. The paper analyzes the results of surgical treatment of 18 patients with schwannomas spread into internal auditory canal. Tumor microsurgical removal was carried out in 12 cases (in 7 cases using endoscopic assistance technique). Fully endoscopic excision of vestibular schwannomas was performed in 6 cases.
Results. Gross total resection was achieved in 16 cases, subtotal resection in 2 cases. Using endoscopic assistance technique during the removal of the intracanal part of the schwannoma provides best visualization along the channel axis. The facial nerve was anatomically preserved in 17 patients (94%), the facial nerve function was preserved in 16 patients (88%), hearing was preserved in 3 patients (16%).
Conclusions. 1) Endoscopic revision of the tumor spread into internal auditory canal is relevant and rational when using microsurgical opening of internal auditory canal; 2) trepanation of internal auditory canal using full endoscopic method (or endoscopic assistance technique) forms a larger trepanation window in internal auditory canal compared to microsurgical method; 3) endoscopic technique provides better visualization of internal auditory canal along its length; 4) Keyhole surgery and endoscopic technique of tumors of the cerebellopontine angle are recommended for small schwannomas (up to24 mm).
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Copyright (c) 2017 Orest I. Palamar, Andriy P. Huk, Dmytro I. Okonskyi, Ruslan V. Aksyonov, Dmytro S. Teslenko
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