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Transcanal surgery for vestibular schwannomas: a pictorial review of radiological findings, surgical anatomy and comparison to the traditional translabyrinthine approach

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The most popular approaches for vestibular schwannoma (VS) removal are retrosigmoid, middle cranial fossa and translabyrinthine (TL). All require a certain degree of invasivity, bone removal, or brain manipulation. Recently, the authors described the transcanal transpromontorial approaches (TTA), which allow the inner ear to be accessed directly through the external auditory canal (EAC), either with a microscopic (Expanded TTA, or ExpTTA) or even an exclusive endoscopic technique (Endoscopic TTA, or EndoTTA). The advantages compared to traditional approaches are a direct view of the internal auditory canal (IAC) from lateral to medial, very little or no superficial tissue dissection and very little petrous bone drilling. In summary, from an anatomical point of view, they could be considered to be minimally invasive approaches. The radiologic outcome and the anatomical correspondence of these new approaches are described so as to share with the readers the possible radiologic findings and to compare and differentiate them from classic transpetrous approaches such as the TL approach.

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References

  1. Ansari SF, Terry C, Cohen-Gadol AA (2012) Surgery for vestibular schwannomas: a systematic review of complications by approach. Neurosurg Focus 33(3):E14

    Article  PubMed  Google Scholar 

  2. Marchioni D, Alicandri-Ciufelli M, Rubini A, Masotto B, Pavesi G, Presutti L (2016) Exclusive endoscopic transcanal transpromontorial approach: a new perspective for internal auditory canal vestibular schwannoma treatment. J Neurosurg 11:1–8

    Google Scholar 

  3. Presutti L, Alicandri-Ciufelli M, Bonali M, Rubini Alessia, Pavesi G, Feletti A, Masotto B, Anschuetz L, Marchioni D (2017) Expanded transcanal transpromontorial approach to the internal auditory canal: pilot clinical experience on 10 cases. Laryngoscope. doi:10.1002/lary.26559 (Epub ahead of print)

  4. Bennett M, Haynes DS (2007) Surgical approaches and complications in the removal of vestibular schwannomas. Otolaryngol Clin North Am 40(3):589–609

    Article  PubMed  Google Scholar 

  5. Thomassin JM, Korchia D, Doris JM (1993) Endoscopic guided otosurgery in the prevention of residual cholesteatomas. Laryngoscope 103:939–943

    Article  CAS  PubMed  Google Scholar 

  6. Presutti L, Marchioni D, Mattioli F, Villari D, Alicandri-Ciufelli M (2008) Endoscopic management of acquired cholesteatoma: our experience. J Otolaryngol Head Neck Surg 37(4):481–487

    PubMed  Google Scholar 

  7. Tarabichi M (2004) Endoscopic management of limited attic cholesteatoma. Laryngoscope 114(7):1157–1162

    Article  PubMed  Google Scholar 

  8. Presutti L, Nogueira JF, Alicandri-Ciufelli M, Marchioni D (2013) Beyond the middle ear: endoscopic surgical anatomy and approaches to inner ear and lateral skull base. Otolaryngol Clin North Am 46(2):189–200

    Article  PubMed  Google Scholar 

  9. Marchioni D, Alicandri-Ciufelli M, Rubini A, Presutti L (2015) Endoscopic transcanal corridors to the lateral skull base: initial experiences. Laryngoscope 125(Suppl 5):S1–S13

    Article  PubMed  Google Scholar 

  10. Marchioni D, Alicandri-Ciufelli M, Mattioli F et al (2013) From external to internal auditory canal: surgical anatomy by an exclusive endoscopic approach. Eur Arch Otorhinolaryngol 270(4):1267–1275

    Article  PubMed  Google Scholar 

  11. Presutti L, Alicandri-Ciufelli M, Cigarini E, Marchioni D (2013) Cochlear schwannoma removed through the external auditory canal by a transcanal exclusive endoscopic technique. Laryngoscope 123(11):2862–2867

    Article  PubMed  Google Scholar 

  12. Patnaik U, Prasad SC, Tutar H, Giannuzzi AL, Russo A, Sanna M (2015) The long-term outcomes of wait-and-scan and the role of radiotherapy in the management of vestibular schwannomas. Otol Neurotol 36(4):638–646

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, Via del Pozzo 71, 41100, Modena, Italy

    Matteo Alicandri-Ciufelli, Gaia Federici, Lukas Anschuetz & Livio Presutti

  2. Otolaryngology-Head and Neck Surgery Department, University Hospital of Verona, Piazzale Ludovico Antonio Scuro, 10, 37100, Verona, Italy

    Daniele Marchioni

  3. Neurosurgery Department, New Civil Hospital Sant’Agostino-Estense, Stradello Baggiovara 53, 41126, Baggiovara, MO, Italy

    Matteo Alicandri-Ciufelli & Giacomo Pavesi

  4. Otolaryngology-Head and Neck Surgery Department, Inselspital, University Hospital and University of Bern, 3010, Bern, Switzerland

    Lukas Anschuetz

  5. Radiology Department, New Civil Hospital Sant’Agostino-Estense, Stradello Baggiovara 53, 41126, Baggiovara, MO, Italy

    Alessandra Todeschini

Authors
  1. Matteo Alicandri-Ciufelli
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  2. Gaia Federici
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  3. Lukas Anschuetz
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  4. Giacomo Pavesi
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  5. Alessandra Todeschini
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  6. Livio Presutti
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  7. Daniele Marchioni
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Corresponding author

Correspondence to Gaia Federici.

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Personal financial interests

LA holds a research fellowship by the Bangerter–Rhyner Foundation, Bern, Switzerland and by Karl Storz GmbH, Tuttlingen, Germany. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

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The authors report no funding for the present study.

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The authors declare no conflict of interests.

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This IRB ethical approval is not required at our institution for this kind of article type.

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Alicandri-Ciufelli, M., Federici, G., Anschuetz, L. et al. Transcanal surgery for vestibular schwannomas: a pictorial review of radiological findings, surgical anatomy and comparison to the traditional translabyrinthine approach. Eur Arch Otorhinolaryngol 274, 3295–3302 (2017). https://doi.org/10.1007/s00405-017-4630-8

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  • DOI: https://doi.org/10.1007/s00405-017-4630-8

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