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Surgical management of vestibular schwannoma: attempted preservation of hearing and facial function

Published online by Cambridge University Press:  03 April 2013

T F Youssef ,
A Matter  and
M R Ahmed
T F Youssef
Affiliation:
Faculty of Medicine, Suez Canal University, Ismailia, Egypt
A Matter
Affiliation:
Faculty of Medicine, Suez Canal University, Ismailia, Egypt
M R Ahmed*
Affiliation:
Faculty of Medicine, Suez Canal University, Ismailia, Egypt
*
Address for correspondence: Dr M R Ahmed, Lecturer in Otolaryngology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt Fax: +20 66 3415603 E-mail: M_rifaat@hotmail.com
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Abstract

Background:

Vestibular schwannomas are benign tumours which usually originate from the vestibular portion of the VIIIth cranial nerve. Treatment options include observation with serial imaging, stereotactic radiation and microsurgical removal.

Aim:

The goal of surgery was complete eradication of tumour with preservation of hearing and facial nerve function.

Methods:

A retrospective review was undertaken of 24 cases of vestibular schwannoma jointly operated upon by a team of neurosurgeons and otologists at the Suez Canal University Hospital, with assessment of VIIth and VIIIth cranial nerve function, tumour size, and extent of growth. All surgery utilised a retromastoid, suboccipital approach.

Results:

Complete tumour removal was achieved in 19 patients. Anatomical preservation of the facial nerve was possible in 66.6 per cent of patients. Pre-operative, useful hearing was present in four patients, and preserved in 80 per cent. Cerebrospinal fluid leakage was diagnosed in two (8.3 per cent) patients, who responded to conservative therapy.

Conclusion:

The retromastoid, suboccipital surgical approach to the skull base can be safely and successfully achieved using a microsurgical technique, with minimal or no damage to neurovascular structures, even for large tumours.

Keywords

NeuromaAcousticHearing LossOtologic Surgical ProceduresEgyptFacial NerveComplications

Information

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 5 , May 2013 , pp. 473 - 478
Copyright
Copyright © JLO (1984) Limited 2013 

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