Vestibular Schwannoma Surgery with Endoscope-Assisted Retrolabyrinthine Approach under Modified Reinforced Continuous Intraoperative Monitoring for Hearing Preservation: Experience of 33 Cases in a Single Center

Makoto Hosoya, Takanori Nishiyama, Takeshi Wakabayashi, Marie N. Shimanuki, Hidemi Miyazaki, Hiroyuki Ozawa, Naoki Oishi

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Surgery for vestibular schwannoma includes various techniques such as the middle cranial fossa, suboccipital, translabyrinthine, and retrolabyrinthine approaches. The retrolabyrinthine approach does not impair the labyrinth and allows postoperative hearing preservation. Previously, we reported an endoscope-assisted retrolabyrinthine approach under reinforced continuous intraoperative monitoring for preservation of hearing and facial nerve function. However, the hearing preservation rate was relatively low in patients with long-wave V latency in the auditory brainstem response or poor otoacoustic emission response under this approach. Thus, the hearing preservation rate in such patients remains to be improved. To overcome this limitation, we modified the previous approach. In 26 of the 33 consecutive cases (79%) over the last three years, preservation of hearing equivalent to that before surgery or improved hearing was achieved. Postoperative deafness was observed in only two of the 33 cases (6%). According to previous reports, the rate of hearing preservation using the retrolabyrinthine approach is approximately 30–50%. Therefore, we have achieved a higher hearing preservation rate than that previously reported using the endoscopy-assisted retrolabyrinthine approach under reinforced continuous intraoperative monitoring. These improvements in our department are considered to be helpful for hearing preservation.

Original languageEnglish
Article number275
JournalDiagnostics
Volume13
Issue number2
DOIs
Publication statusPublished - 2023 Jan

Keywords

  • DNAP
  • hearing preservation surgery
  • monitoring
  • retrolabyrinthine approach
  • vestibular schwannoma

ASJC Scopus subject areas

  • Clinical Biochemistry

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