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Modified translabyrinthine approach and hearing preservation.

Giuseppe Magliulo1, Donato Parrotto, Alessandro Stasolla

  • 1G. Ferreri Department of Otorhinolaryngology, Audiology, and Phoniatrics, La Sapienza University, Rome, Italy. giuseppemagliuloorl@yahoo.com

The Laryngoscope
|June 5, 2004
PubMed
Summary

This study shows that a modified translabyrinthine approach preserved hearing in 50% of patients with small vestibular schwannomas. The approach also ensured excellent facial nerve function and no tumor recurrence.

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Area of Science:

  • Neurosurgery
  • Otolaryngology
  • Oncology

Background:

  • The translabyrinthine approach is a surgical method for accessing the cerebellopontine angle.
  • A modification involving sealing the vestibule with bone wax was previously reported to preserve hearing.
  • Vestibular schwannomas involving the internal auditory canal present challenges for hearing preservation surgery.

Purpose of the Study:

  • To evaluate the effectiveness of a modified translabyrinthine approach in preserving hearing function.
  • To assess hearing preservation in patients with vestibular schwannoma involving the internal auditory canal.

Main Methods:

  • Prospective study of 12 patients with vestibular schwannoma (smaller than 2 cm).
  • Patients were required to have preserved hearing function prior to surgery.

Related Experiment Videos

  • The modified translabyrinthine approach with vestibule sealing was employed.

    • Main Results:

    • 50% of patients (6 out of 12) maintained hearing function (Class 1 or 2 Gardner-Robertson scale).
    • Excellent facial nerve functionality was observed immediately post-surgery in all patients.
    • No tumor recurrence or persistence was detected on postoperative MRI; no major complications occurred.

    Conclusions:

    • The modified translabyrinthine approach is a promising technique for hearing preservation in selected vestibular schwannoma patients.
    • The study achieved a 50% hearing preservation rate with no tumor recurrence in the short follow-up period.
    • Further comprehensive studies are warranted to confirm these encouraging initial results.