Endoscope‐assisted resection of intravestibular Schwannoma: A video case report

Pan, Cassie; Sewell, Andrew; Michaelides, Elias

doi:10.1002/lary.27605

Cited by 4 publications

(6 citation statements)

References 11 publications

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“…Endoscopes may decrease the need for dissection of normal structures for the sake of exposure and enhance quality of visualization around deep angles and recesses. 4,19 While commonly used for resection of cholesteatoma and tympanoplasty, the endoscope has also been successfully utilized to resect ILS and ensure macroscopic clearance of disease. 4,8,12,20 Pan and colleagues 4 reported an endoscopic-assisted resection of an ILS in 2019.…”

Section: Discussionmentioning

confidence: 99%

“…4,19 While commonly used for resection of cholesteatoma and tympanoplasty, the endoscope has also been successfully utilized to resect ILS and ensure macroscopic clearance of disease. 4,8,12,20 Pan and colleagues 4 reported an endoscopic-assisted resection of an ILS in 2019. This was followed by Ma et al, 8 who in 2020 reported an endoscopic-assisted resection of ICS followed by immediate cochlear implantation.…”

Section: Discussionmentioning

confidence: 99%

“…3 Specifically, intracochlear schwannoma (ICS) accounts for over 50% of all ILS. 4 Patients with ICS commonly present with unilateral sensorineural hearing loss. 2,5 Tinnitus, vertigo, and aural fullness may also be present.…”

Section: Introductionmentioning

confidence: 99%

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Resection of Intracochlear Schwannomas With Immediate Cochlear Implantation

Patel

Fleischer

Wiet

et al. 2022

Ann Otol Rhinol Laryngol

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Introduction: Intralabyrinthine schwannomas, including the intracochlear variety, are rare benign tumors. They can cause a number of symptoms and have the potential to grow to involve other critical structures of the inner ear and skull base. While surgical resection is feasible, there is typically permanent hearing dysfunction as a result of resection and subsequent fibrosis. Here, we present 2 cases of intracochlear schwannomas (ICS) that were successfully resected with simultaneous cochlear implant placement. Methods: Patient 1 presented with an intravestibulocochlear schwannoma. This patient underwent a translabyrinthine approach. Endoscopic assistance was used to dissect the tumor from the vestibule and basal turn of the cochlea, through an enlarged round window approach. A cochlear implant was placed via a round window cochleostomy. Patient 2 presented with an intracochlear schwannoma involving the basal and middle turns of the cochlea. The patient underwent a trans-otic approach for resection. A large portion of the cochlear promontory required unroofing for complete exposure of the tumor. A cochlear implant was then placed via a round window cochleostomy. Results: Upon cochlear implant activation, Patient 1’s sound field thresholds using the implant were near the normal range of hearing, ranging from 25 to 50 dB HL from 250 to 6000 Hz. Patient 2’s 6-month post-operative cochlear implant sound field testing ranged from 20 to 30 dB HL from 250 to 6000 Hz and speech recognition testing revealed 59% on AZ Bio sentences compared to 0% pre-operatively. Conclusion: Simultaneous cochlear implantation after resection of intracochlear schwannomas is safe and successful in restoring hearing. Attention to adequate exposure and endoscopic assistance, when required, allow for gross total resection while minimizing trauma to cochlear structures. In such cases, immediate cochlear implantation allows for hearing rehabilitation before likely cochlear fibrosis can occur.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Resection of Intracochlear Schwannomas With Immediate Cochlear Implantation

Patel

Fleischer

Wiet

et al. 2022

Ann Otol Rhinol Laryngol

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“…“Vestibulocochlear ILS” is another type of ILS that affects the cochlea and vestibule ± semicircular canals contribution. The last type in this classification is “transotic ± cerebellopontine angle” (tumor in cochlea and/or in the vestibular portion of the inner ear; extension into the middle ear and into the IAC with or without extension to CPA) 1,2. The symptoms of ILS are similar to other cochleovestibular disorders and are not specific to the disease.…”

Section: Diagnosis: Intravestibular Schwannomamentioning

confidence: 99%

“…The presentation of intravestibular schwannomas is unilateral sensorineural hearing loss and the vestibular symptoms are most often observed in patients 2. Schwannomas associated with these symptoms usually exhibit gadolinium contrast enhancement on T1-weighted images and a “filling defect” on T2 or CISS images 1,2…”

Section: Diagnosis: Intravestibular Schwannomamentioning

confidence: 99%

Symptoms: Asymmetric Hearing Loss and Episodic Vertigo

Mazhari,

Tawk,

Abouzari

et al. 2023

The Hearing Journal

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The Role of Endoscopy in the Resection of Sporadic Vestibular Schwannomas: A Systematic Review of Surgical Outcomes

Raza-Knight

Chiuta

Golash

et al. 2021

Otology &Amp; Neurotology

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Background: Vestibular schwannomas (VS) are benign intracranial tumors originating from the vestibular division of the eighth cranial nerve. Treatment options include microsurgery, radiotherapy, and surveillance. Endoscopy is becoming more widely used as an adjunct in skull base surgery and may influence outcomes in surgically managed VS. Methods: A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies involving endoscope-assisted and fully endoscopic procedures for sporadic VS resection were identified. Facial nerve function, hearing preservation, extent of resection, and complications were analyzed. Results: Thirty-one studies were included (27 endoscopeassisted, four fully endoscopic). Subgroup analyses were performed to assess outcomes according to tumor size and surgical approach. Overall, endoscopic facial nerve preservation rates were comparable to microsurgical treatment. A subgroup analysis suggested that functional facial nerve preservation rates may be higher when endoscopic assis-tance is used for smaller (Koos I-II) tumors using the retrosigmoid or translabyrinthine approach. The gross total resection rate for small tumors was higher in retrosigmoid ES-assisted microsurgery (96.2%) compared to rates in the literature for the standard, open retrosigmoid approach. Hearing outcomes were more variable and were underreported. Conclusions: Current data suggest that ES-assisted resection of sporadic VS is not inferior to microsurgical resection with respect to facial nerve outcomes and extent of resection. However, some ES series report poor hearing outcomes, which are under-reported in the literature. Further prospective studies are required to ascertain if endoscopic assistance can improve outcomes for VS resection, particularly for smaller (Koos I-II) tumors.

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Endoscope‐assisted resection of intravestibular Schwannoma: A video case report

Cited by 4 publications

References 11 publications

Resection of Intracochlear Schwannomas With Immediate Cochlear Implantation

Resection of Intracochlear Schwannomas With Immediate Cochlear Implantation

Symptoms: Asymmetric Hearing Loss and Episodic Vertigo

The Role of Endoscopy in the Resection of Sporadic Vestibular Schwannomas: A Systematic Review of Surgical Outcomes

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