Full Endoscopic Resection of Intralabyrinthine Schwannomas: A Case Series

Abstract

Objective: To investigate the technique and efficacy of fully endoscope resection of intralabyrinthine schwannomas (ILS) by transcanal transpromontorial endoscopic approach (TTEA). Study Design: Retrospective case review. Setting: Hospital. Patients: All patients who were affected by ILS, without extension to the internal auditory canal and underwent surgery with TTEA in our hospital in 2020. Intervention(s): Therapeutic. Main Outcome Measure(s): Recovery status, postoperative complications and remaining symptoms after surgery. Results: Three patients were included, all of which underwent gross total resections. The follow-up period was from 10 months to 2 years. No intraoperative and postoperative major complications were observed. There was no facial paralysis or cerebrospinal fluid leakage postoperatively. The hospitalization time of TTEA was 5 days. Three patients’ vertigo was relieved after 1 week without receiving vestibular therapy. Only 1 patient complained of transient episodes of vertigo when climbing or holding heavy objects. Conclusions: TTEA has the advantages of clear vision to identify the anatomical structure, enabling complete tumor resection, reduced operation time, and faster postoperative recovery. Level of Evidence: IV

A Case Report Demonstrating Preservation of Vestibular Receptor Function after Transcochlear Removal of an Intracochlear Schwannoma with Extension to the Fundus of the Internal Auditory Canal

“…but complaints of transient episodes of vertigo (1-3 s) when climbing or lifting heavy objects." [35]. Endoscopic approaches for the surgical removal of intracochlear schwannomas with or without extension to the fundus of the IAC have also been suggested by other authors [36,37].…”

“…Laborai et al (2022) showed that vestibular disfunction (areflexia to caloric test and reduced ipsilateral vHIT gain) of a patient with an intracochlear schwannoma treated with a “CI through tumour” strategy remained unchanged after the surgery “with just a slight increase in VOR asymmetry in the vHIT from 41% to 57% at one month and to 64% at six months” [ 34 ]. Wu et al (2023) reported a case of endoscopic surgical removal of an intracochlear IES with “no severe episodes of vertigo at follow-up for 11 months to 2 years … but complaints of transient episodes of vertigo (1–3 s) when climbing or lifting heavy objects.” [ 35 ]. Endoscopic approaches for the surgical removal of intracochlear schwannomas with or without extension to the fundus of the IAC have also been suggested by other authors [ 36 , 37 ].…”

“…Laborai et al (2022) showed that vestibular disfunction (areflexia to caloric test and reduced ipsilateral vHIT gain) of a patient with an intracochlear schwannoma treated with a "CI through tumour" strategy remained unchanged after the surgery "with just a slight increase in VOR asymmetry in the vHIT from 41% to 57% at one month and to 64% at six months" [34]. Wu et al (2023) reported a case of endoscopic surgical removal of an intracochlear IES with "no severe episodes of vertigo at follow-up for 11 months to 2 years . .…”