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Combined Endoscopic and Microscopic Surgery for Perilabyrinthine Lesions: Feasibility and Technique
Xingmei Wei1, Zhiqiang Gao, Xu Tian
1Department of Otorhinolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China.
Objectives:
To determine the feasibility of endoscopic-assisted surgery for lesions involving the perilabyrinthine recesses, and develop and validate a technique for this kind of lesions that increases the possibility of preserving the labyrinth and cochlea.
Study Design:
Observational study.
Setting:
Referral center.
Cases:
Five patients who underwent endoscopy-assisted surgery for lateral skull base pathology involving the perilabyrinthine recesses between July 2010 and March 2016 were reviewed.
Interventions:
Clinical data of the five patients were collected.
Main Outcomes Measures:
Hearing level and recurrence.
Results:
Three of the five patients (three women, two men) had petrous bone cholesteatomas, one a facial neurofibroma, and one a petrous bone cholesterol granuloma. Complete excision with labyrinth and cochlea preservation was achieved using an endoscopic-assisted technique in all patients. Four had preoperative conductive hearing loss and one was totally deaf. In one patient, the postoperative air-bone gap was 30 dB lower than preoperatively levels, one stayed the same, and one was 30 dB because of closing of the external ear canal. After an average follow-up of 62.9 months, no patient had recurrence.
Conclusions:
Endoscope-assisted surgery is feasible for lesions involving the perilabyrinthine recesses and increases the likelihood to preserve the structure and function of labyrinth/cochlea, which may provide chances for artificial hearing devices implantation.
