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Updated: Jul 15, 2026

Endoscopic Approach for Colloid Cyst Resection
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Endoscopic Approach for Colloid Cyst Resection

Published on: May 23, 2025

Endoscopic Versus Microscopic Retrosigmoid Approach for Vestibular Schwannoma Resection.

Fareeha Nisar1, Zanib Javed1, Muhammad Shahzad Shamim1

  • 1Department of Surgery, Aga Khan University Hospital, Pakistan.

JPMA. the Journal of the Pakistan Medical Association
|July 14, 2026
PubMed
Summary

Fully endoscopic surgery for vestibular schwannomas matches microscopic results for tumor removal and facial nerve preservation. Endoscopic techniques offer better visualization and potentially improve recovery, especially for tumors in the internal auditory canal.

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Area of Science:

  • Neurosurgery
  • Otolaryngology
  • Surgical Oncology

Background:

  • Vestibular schwannomas are benign tumors requiring surgical management focused on preserving neurological function and quality of life.
  • The retrosigmoid approach, traditionally using an operating microscope, is a common surgical corridor.
  • Limitations in microscopic visualization, especially within the internal auditory canal, have driven interest in endoscopic techniques.

Purpose of the Study:

  • To review and evaluate current evidence comparing fully endoscopic, endoscopic-assisted, and conventional microscopic retrosigmoid approaches for vestibular schwannomas.
  • To assess the efficacy and safety of different retrosigmoid techniques regarding tumor resection and neurological preservation.

Main Methods:

  • Systematic review of comparative studies on retrosigmoid approaches for vestibular schwannomas.
Keywords:
Vestibular Schwannoma, Retrosigmoid approach, Miscroscopic surgery, Endoscopic

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  • Analysis of data comparing gross total resection rates, facial nerve preservation, and postoperative outcomes.
  • Evaluation of visualization capabilities and surgical invasiveness across different techniques.

    • Main Results:

    • Fully endoscopic surgery demonstrates outcomes comparable to microscopic approaches for gross total resection and facial nerve preservation.
    • Endoscopic techniques provide enhanced visualization of difficult-to-access anatomical regions, potentially improving resection extent, particularly for intracanalicular tumors.
    • Endoscopic approaches are associated with reduced surgical invasiveness, leading to improved postoperative recovery and decreased morbidity.

    Conclusions:

    • Fully endoscopic retrosigmoid surgery is a viable alternative to microsurgery for vestibular schwannomas, offering comparable oncological and functional outcomes.
    • Endoscopic techniques enhance visualization and may improve surgical results, especially for complex tumors.
    • Endoscopic-assisted microsurgery serves as a practical transitional method, while fully endoscopic approaches offer significant advantages in minimally invasive surgery.