NEUROSURGICAL MANAGEMENT OF VESTIBULAR SCHWANNOMAS THROUGH RETROSIGMOID APPROACH
DOI:
https://doi.org/10.54890/.v1i1(1).975Abstract
To identify the actual benefits and persisting problems in management of vestibular schwannomas by the suboccipital retrosigmoid approach. The results and complications in a consecutive series of 120 tumours surgically treated were analysed and compared with experience involving other treatment modalities.
Methods: Pre-and postoperative clinical statuses were determined, radiological and surgical findings were collected and evaluated a database for 120 patients undergoing 125 vestibular schwannoma operations.
Results: By the suboccipital retrosigmoid approach, 109 tumours were completely removed; in 16 cases, deliberate partial removal was performed either in severely ill patients for decompression of the brain stem or in an attempt to preserve hearing in the last hearing ear. Surgical complications included hematomas in 2.2% of the cases, cerebrospinal fluid fistulas in 9.2%, hydrocephalus in 2.3%, bacterial meningitis in 1.2%, and wound revisions in 1.1 %.
Conclusion: The current treatment options of complete tumour resection with ongoing reduction morbidity are well fulfilled by the suboccipital retrosigmoid approach.
Keywords:
Acoustic neuroma, caudal cranial nerves, facial nerve, suboccipital approach, complications.References
1. Махмудов У.Б. Хирургическое лечение неврином слухового нерва: Автореф. дис. … д-ра мед. наук: 14.00.28. - М., 1981. - 23с.
2. Никитин И.А. Хирургия больших и гигантских неврином VIII нерва: Автореф. дис. …д-ра мед. наук: 14.00.28. - Л., 1989. - 35с.
3. Рзаев Д.А., Шулев Ю.А., Бикмуллин В.Н. Ретросигмоидный доступ как основа малоинвазивной хирургии мосто-мозжечкового угла // III съезд нейрохирургов России, Санкт-Петербург, 4-8 июня, 2002 г. - С.144-145.
4. Смеянович А.Ф. Микронейрохирургия неврином слухового нерва: Автореф. дис. … д-ра мед. наук: 14.00.28. - Киев, 1981. - 44с.
5. Халед Бу Х.Э. Диагностика и хирургическое лечение неврином слухового нерва: Автореф. дис. …канд. мед. наук: 14.00.28. - М., 1993. - 18с.
6. Ырысов К.Б. Диагностика и нейрохирургическое лечение вестибулярных шванном (неврином VIII нерва): Дис... д-ра мед.наук: 14.00.28. – Бишкек, 2005. – 200с.
7. Ebersol M.J., Harner S.G., Beatty C.W. Current results of the retrosigmoid approach to acoustic neuroma. // J Neurosurg., 2009. - Vol. 76. – P. 901-909.
8. Schessel D.A. Recurnence rates of acoustic neuroma in hearing preservation surgery. // Am J Otol., 2008. - Vol. 13.- P. 233-235.
9. Tatagiba M., Matthies C., Samii M. Microendoscopy of the internalduditory canal in vestibular schwannoma surgery. // Neurosurgery, 1996. - Vol. 38. – P. 737-740.
10. Tos M. Causes of facial nerve paresis after translabyrinthine surgery for acoustic neuroma. // Ann Otd Rhinol Laryngol., 2009. - Vol. 101. – P. 821-826.
Downloads
Published
How to Cite
Issue
Section
