Hearing preservation in vestibular schwannoma surgery via retrosigmoid transmeatal approach
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Advances in various diagnostic and/or treatment modalities, including radiological imaging, neuromonitoring, and microsurgical techniques, have resulted in treatments of vestibular schwannomas being aimed at preserving facial and hearing functions while achieving optimal tumor control.
We describe our surgical technique for hearing preservation in vestibular schwannoma surgery.
The retrosigmoid transmeatal approach under continuous neuromonitoring (auditory brainstem response, cochlear nerve action potentials, and continuous facial nerve monitoring) enables gross-total resection of vestibular schwannomas, while preserving hearing and facial functions. Radiological assessment and microsurgical techniques, such as meticulous tumor dissection, are also essential for functional preservation with sufficient tumor removal.
KeywordsAcoustic neuroma Cerebellopontine angle tumor Internal acoustic meatus Lateral suboccipital approach Neuromonitoring Skull base surgery
Auditory brainstem response
Cochlear nerve action potentials
Magnetic resonance imaging
Somatosensory evoked potential
We thank Ms. Miki Hioki and Mr. Yoshifumi Kawaguchi for their support as medical technologists.
Compliance with ethical standards
Informed consent was obtained from a participant included in this study.
Conflict of interest
The authors declare that they have no conflict of interest.
This video shows hearing preservation surgery for a left vestibular schwannoma via the retrosigmoid transmeatal approach under ABR, CNAP, and continuous facial nerve monitoring. (MP4 237191 kb)
- 7.Quiñones-Hinojosa A, Chang EF, Lawton MT (2006) The extended retrosigmoid approach: an alternative to radical cranial base approaches for posterior fossa lesions. Neurosurgery. 58(4 Suppl 2):ONS-208-214 discussion ONS-214Google Scholar