Background: Recently, the transcanal approach for the removal of acoustic neuromas has been introduced. Facial nerve (FN) preservation is one of the main challenges of this kind of surgery. Objective: To describe our experience in the surgical treatment of acoustic neuromas, focusing on the functional results of FN preservation after a transcanal approach. Methods: A retrospective chart review was carried out on clinical data and videos from operations on 49 patients who underwent surgery with a totally transcanal exclusive endoscopic approach for Koos stage I-II lesions, or an enlarged transcanal transpromontorial approach for Koos stage II-III tumors, between March 2012 and February 2017. Patients and tumor characteristics, clinical manifestations, radiologic features, audiological results, FN outcomes (according to the House-Brackmann [HB] grading system) and complications were evaluated. Tumors were classified according to the Koos grading system. Results: The age of the patients (34 females and 15 males) ranged from 27 to 77 years (mean age: 54.9 yr). Preoperative diagnosis was "vestibular schwannoma" in all patients. At the last follow-up (range 1-60 mo, mean 13.9 mo), 42 of 49 showed grade I HB FN function, 5 of 49 grade II HB, and 2 of 49 grade III HB. Overall, in 95.9%, FN function was preserved (grade I-II HB) with stable results at follow-up; in 4.1% of cases, FN function was reduced, but not worse than grade III. Conclusion: The transcanal approach represents a feasible, minimally invasive, and conservative technique for the management of acoustic neuromas of the internal auditory canal.

Transcanal Transpromontorial Acoustic Neuroma Surgery: Results and Facial Nerve Outcomes / Marchioni, Daniele; Soloperto, Davide; Masotto, Barbara; Fabbris, Cristoforo; De Rossi, Stefano; Villari, Domenico; Presutti, Livio. - In: OTOLOGY & NEUROTOLOGY. - ISSN 1531-7129. - 39:2(2018), pp. 242-249. [10.1097/MAO.0000000000001658]

Transcanal Transpromontorial Acoustic Neuroma Surgery: Results and Facial Nerve Outcomes

Marchioni, Daniele;Soloperto, Davide;Villari, Domenico;Presutti, Livio
2018

Abstract

Background: Recently, the transcanal approach for the removal of acoustic neuromas has been introduced. Facial nerve (FN) preservation is one of the main challenges of this kind of surgery. Objective: To describe our experience in the surgical treatment of acoustic neuromas, focusing on the functional results of FN preservation after a transcanal approach. Methods: A retrospective chart review was carried out on clinical data and videos from operations on 49 patients who underwent surgery with a totally transcanal exclusive endoscopic approach for Koos stage I-II lesions, or an enlarged transcanal transpromontorial approach for Koos stage II-III tumors, between March 2012 and February 2017. Patients and tumor characteristics, clinical manifestations, radiologic features, audiological results, FN outcomes (according to the House-Brackmann [HB] grading system) and complications were evaluated. Tumors were classified according to the Koos grading system. Results: The age of the patients (34 females and 15 males) ranged from 27 to 77 years (mean age: 54.9 yr). Preoperative diagnosis was "vestibular schwannoma" in all patients. At the last follow-up (range 1-60 mo, mean 13.9 mo), 42 of 49 showed grade I HB FN function, 5 of 49 grade II HB, and 2 of 49 grade III HB. Overall, in 95.9%, FN function was preserved (grade I-II HB) with stable results at follow-up; in 4.1% of cases, FN function was reduced, but not worse than grade III. Conclusion: The transcanal approach represents a feasible, minimally invasive, and conservative technique for the management of acoustic neuromas of the internal auditory canal.
2018
39
2
242
249
Transcanal Transpromontorial Acoustic Neuroma Surgery: Results and Facial Nerve Outcomes / Marchioni, Daniele; Soloperto, Davide; Masotto, Barbara; Fabbris, Cristoforo; De Rossi, Stefano; Villari, Domenico; Presutti, Livio. - In: OTOLOGY & NEUROTOLOGY. - ISSN 1531-7129. - 39:2(2018), pp. 242-249. [10.1097/MAO.0000000000001658]
Marchioni, Daniele; Soloperto, Davide; Masotto, Barbara; Fabbris, Cristoforo; De Rossi, Stefano; Villari, Domenico; Presutti, Livio
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1154362
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