Fully Endoscopic Excision of Vestibular Schwannomas

Shahinian, Hrayr K.; Eby, Joseph B.; Ocón, María del Mar

doi:10.1055/s-2004-830122

Cited by 40 publications

(26 citation statements)

References 5 publications

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“…This will allow the skull base surgeon improved access to regions of the brain that have traditionally required either more bone removal or intraparenchymal corridors. Facility with the simple microvascular decompression will allow the surgeon to tackle more complex pathology [15], perhaps even minimizing the morbidity associated with petroclival meningiomas in the future.…”

Section: Discussionmentioning

confidence: 99%

Fully Endoscopic Microvascular Decompression: Our Early Experience

Halpern

Lang

Lee

2013

Minimally Invasive Surgery

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Background. Microvascular decompression (MVD) is a widely accepted treatment for neurovascular disorders associated with facial pain and spasm. The endoscope has rapidly become a standard tool in neurosurgical procedures; however, its adoption in lateral approaches to the posterior fossa has been slower. The endoscope is used primarily to assist conventional microscopic techniques. We are interested in developing fully endoscopic approaches to the cerebellopontine angle, and here, we describe our preliminary experience with this procedure for MVD. Methods. A retrospective review of our two-year experience from 2011 to 2012, transitioning from using conventional microscopic techniques to endoscope-assisted microsurgery to fully endoscopic MVD, is provided. We also reviewed our preliminary outcomes during this transition. Results. There was no difference in the surgical duration of these three procedures. In addition, the majority of procedures performed in 2012 were fully endoscopic, suggesting the ease of incorporating this solo tool into practice. Pain outcomes of fully endoscopic MVD appear to be very similar to those of both conventional and endoscope-assisted MVDs. Complications occurred in all groups at equally low rates. Conclusion. Fully endoscopic MVD is both safe and effective. By enhancing visualization of structures within the cerebellopontine angle, endoscopy may prove to be a valuable adjunct or alternative to conventional microscopic approaches.

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Section: Discussionmentioning

confidence: 99%

Fully Endoscopic Microvascular Decompression: Our Early Experience

Halpern

Lang

Lee

2013

Minimally Invasive Surgery

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“…Following identification of the critical surrounding structures, the tumor is resected. Shahinian et al [9] recently reported their experience with an endoscopic retrosigmoid approach in the treatment of vestibular schwannomas. The authors reported complete excision of the tumors with only a mild degree of facial nerve palsy (grades I-III on the six grade severity scale).…”

Section: Surgerymentioning

confidence: 99%

Peripheral and cranial nerve sheath tumors

Mrugala

Batchelor

Plotkin

2005

Current Opinion in Neurology

100

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Peripheral nerve tumors are classified according to the specific features of cellular differentiation. The most common types include schwannoma and neurofibroma. These tumors can occur sporadically or as manifestations of genetic syndromes such as neurofibromatosis types 1 and 2 or schwannomatosis. The majority of peripheral nerve tumors are benign but malignant transformation does occur. Metastatic tumors can also affect peripheral nerves. The diagnostic modality of choice is magnetic resonance imaging. Positron emission tomography is a useful technique in the presurgical differentiation between benign and malignant peripheral nerve sheath tumors. Treatment is directed towards symptomatic control. Surgery, radiation and, in rare instances, chemotherapy are the major treatment modalities employed.

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“…Recently, the Shahinian group in Los Angeles [48,49,50] published a series of case reports of endoscopic vascular decompressions (EVD) for the treatment of trigeminal neuralgia, glossopharyngeal neuralgia, and excision of vestibular schwannomas. Their initial results highlight the many advantages of purely endoscopic approaches, namely the superior visualization of the anatomy and panoramic views, thus facilitating the decompression through the available operating window with otherwise narrow views.…”

Section: Xen For Posterior Fossa and Cerebellopontine Angle Lesionsmentioning

confidence: 99%

Endoscopic Minimally Invasive Neurosurgery: Emerging Techniques and Expanding Role through an Extensive Review of the Literature and Our Own Experience – Part II: Extraendoscopic Neurosurgery

et al. 2011

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Background/Aims: The field of minimally invasive neurosurgery has grown dramatically especially in the last decades. This has been possible, in the most part, due to the advancements in technology especially in tools such as the endoscope. The contemporary classification scheme for endoscopic procedures needs to advance as well. Methods: The present classification scheme for neuroendoscopic procedures has become confusing because it mainly describes the use of the endoscope as an assisting device to the microscope. The authors propose an update to the current classification that reflects the independence of the endoscope as a tool in minimally invasive neurosurgery. Results: The proposed classification groups the procedures as ‘intraendoscopic’ neurosurgery or ‘extraendoscopic’ neurosurgery (XEN) in relation to the ‘axis’ of the endoscope. A review of the literature for the XEN group together with exemplary cases is presented. Conclusion: We presented our proposed classification for the endoscope-only surgical procedures. The XEN group is expanded in this article.

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Fully Endoscopic Excision of Vestibular Schwannomas

Cited by 40 publications

References 5 publications

Fully Endoscopic Microvascular Decompression: Our Early Experience

Fully Endoscopic Microvascular Decompression: Our Early Experience

Peripheral and cranial nerve sheath tumors

Endoscopic Minimally Invasive Neurosurgery: Emerging Techniques and Expanding Role through an Extensive Review of the Literature and Our Own Experience – Part II: Extraendoscopic Neurosurgery

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