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The transmastoid retrolabyrinthine approach in vestibular schwannoma surgery
Ricardo Ferreira Bento1, Rubens Vuono De Brito, Tanit Ganz Sanchez
1Otolaryngology Department, University of São Paulo School of Medicine, Brazil. rbento@attglobal.net
Objective:
We conducted a prospective analysis of 22 patients with small vestibular schwannoma and useful hearing who were operated on via a transmastoid retrolabyrinthine approach between January 1994 and March 1999.
Patients And Methods:
The average age was 35 years, and there were 14 females and 8 males. All patients had unilateral tumors, with 10 of them occurring in the right ear and 12 occurring in the left ear. The following parameters were included in our protocol: total removal of the tumor, intraoperative difficulties or complications, immediate postoperative complications, facial score 10 days and 3 months after the surgery, and audiologic evaluation 90 days after the surgery.
Results:
A good exposure of the internal auditory canal was possible in 19 cases. In 3 patients we had to change the approach to a translabyrinthine one to achieve total removal of the tumor in all patients. Hearing was preserved at the same preoperative levels in 31% of the cases.
Conclusions:
The retrolabyrinthine approach offered security to the facial nerve, no morbidity, and good percentage of hearing preservation. It is also easily changeable to a translabyrinthine approach when more exposure is necessary.