Modifying the translabyrinthine approach to preserve hearing during acoustic tumour surgery

1991 ◽  
Vol 105 (1) ◽  
pp. 34-37 ◽  
Author(s):  
John T. McElveen ◽  
Robert H. Wilkins ◽  
Andrea C. Erwin ◽  
Robert D. Wolford
Keyword(s):  
Hearing Preservation ◽  
Vestibular Nerve ◽  
Translabyrinthine Approach ◽  
Inferior Vestibular Nerve ◽  
Acoustic Schwannoma ◽  
Acoustic Tumour

AbstractRemoving an acoustic schwannoma using the translabyrinthine approach has previously been considered incompatible with hearing preservation. By modifying the approach and preventing the loss of endolymph, we have successfully removed an intracanalicular acoustic schwannoma, which originated from the inferior vestibular nerve, and preserved hearing in the operated ear. This report represents the preliminary findings using this particular technique in the management of an intracanalicular acoustic tumour.

Tumor origin and hearing preservation in vestibular schwannoma surgery

2011 ◽  
Vol 115 (5) ◽  
pp. 900-905 ◽  
Author(s):  
Jens Rachinger ◽  
Stefan Rampp ◽  
Julian Prell ◽  
Christian Scheller ◽  
Alex Alfieri ◽  
...  
Keyword(s):  
Vestibular Schwannoma ◽  
Tumor Size ◽  
Hearing Preservation ◽  
Vestibular Nerve ◽  
Cochlear Nerve ◽  
Nerve Function ◽  
Nerve Preservation ◽  
Tumor Origin ◽  
Inferior Vestibular Nerve ◽  
Vs Removal

Object Preservation of cochlear nerve function in vestibular schwannoma (VS) removal is usually dependent on tumor size and preoperative hearing status. Tumor origin as an independent factor has not been systematically investigated. Methods A series of 90 patients with VSs, who underwent surgery via a suboccipitolateral route, was evaluated with respect to cochlear nerve function, tumor size, radiological findings, and intraoperatively confirmed tumor origin. All patients were reevaluated 12 months after surgery. Results Despite comparable preoperative cochlear nerve status and larger tumor sizes, hearing preservation was achieved in 42% of patients with tumor originating from the superior vestibular nerve, compared with 16% of those with tumor originating from the inferior vestibular nerve. Conclusions Tumor origin is an important prognostic factor for cochlear nerve preservation in VS surgery.

Nerve origin of vestibular schwannoma: a prospective study

2007 ◽  
Vol 122 (2) ◽  
pp. 128-131 ◽  
Author(s):  
T Khrais ◽  
G Romano ◽  
M Sanna
Keyword(s):  
Vestibular Schwannoma ◽  
Tumour Size ◽  
Internal Auditory Canal ◽  
Hearing Preservation ◽  
Middle Cranial Fossa ◽  
Vestibular Nerve ◽  
Case Review ◽  
Explanatory Factors ◽  
Inferior Vestibular Nerve ◽  
A Prospective Study

AbstractObjective:The origin of vestibular schwannoma has always been a matter of debate. The aim of our study was to identify the nerve origin of this tumour.Study design:Prospective case review. This study was conducted at Gruppo Otologico, a private referral centre for neurotology and skull base surgery.Methods:A total of 200 cases of vestibular schwannoma were included in the study. All the tumours were removed surgically utilising the translabyrinthine approach. The origin of the tumour was sought at the fundus of the internal auditory canal.Results:A total of 200 consecutive cases was included in the study. The origin of the tumour was limited to one nerve at the fundus in 152 cases (76 per cent). Out of these cases, the tumour originated from the inferior vestibular nerve in 139 cases (91.4 per cent), from the superior vestibular nerve in nine cases (6 per cent), from the cochlear nerve in two cases (1.3 per cent) and from the facial nerve in two cases (1.3 per cent).Conclusion:The vast majority of vestibular schwannomas originate from the inferior vestibular nerve; the incidence of involvement of this nerve increases as the tumour size increases. An origin of vestibular schwannoma from the inferior vestibular nerve can be considered as one of the explanatory factors for the poor functional outcome of the extended middle cranial fossa approach, and probably accounts also for the better hearing preservation rate reported in some series for the retrosigmoid approach.

Translabyrinthine Approach for Acoustic Neuroma

Neurosurgery ◽  
2004 ◽  
Vol 54 (2) ◽  
pp. 391-396 ◽  
Author(s):  
John Diaz Day ◽  
Douglas A. Chen ◽  
Moises Arriaga
Keyword(s):  
Surgical Treatment ◽  
Acoustic Neuroma ◽  
Cerebellopontine Angle ◽  
Hearing Preservation ◽  
Retrosigmoid Approach ◽  
The Past ◽  
Translabyrinthine Approach ◽  
Acoustic Neuromas

Abstract THE TRANSLABYRINTHINE APPROACH has been popularized during the past 30 years for the surgical treatment of acoustic neuromas. It serves as an alternative to the retrosigmoid approach in patients when hearing preservation is not a primary consideration. Patients with a tumor of any size may be treated by the translabyrinthine approach. The corridor of access to the cerebellopontine angle is shifted anteriorly in contrast to the retrosigmoid approach, resulting in minimized retraction of the cerebellum. Successful use of the approach relies on a number of technical nuances that are outlined in this article.

Imaging case study: enlarged superior vestibular nerve canal with sensorineural hearing loss

2008 ◽  
Vol 123 (5) ◽  
pp. 572-574 ◽  
Author(s):  
M I Redleaf ◽  
J M Pinto ◽  
J J Klemens
Keyword(s):  
Computed Tomography ◽  
Hearing Loss ◽  
Case Report ◽  
Sensorineural Hearing Loss ◽  
Temporal Bone ◽  
Male Infant ◽  
Vestibular Nerve ◽  
Sensorineural Hearing ◽  
Inferior Vestibular Nerve

AbstractObjective:We report a new temporal bone anomaly – an enlarged superior vestibular nerve canal – associated with sensorineural hearing loss.Case report:A 10-month-old male infant presented with sensorineural hearing loss together with bilaterally enlarged superior vestibular nerve canals. Compared with published temporal bone computed tomography measurements, our patient's canals were normal in length but approximately double the normal width. In addition, careful review of the imaging did not clearly identify a bony wedge between the superior and inferior vestibular nerve canals.Conclusion:Enlarged superior vestibular nerve canal malformation may be a marker for sensorineural hearing loss. Increased vigilance amongst otologists may establish the prevalence of this anomaly and its possible effects on hearing.

Hearing Preservation After Translabyrinthine Vestibular Schwannoma Excision: Audiometry and Electrocochleography Results

2018 ◽  
Vol 127 (8) ◽  
pp. 563-567 ◽  
Author(s):  
Kenneth Akakpo ◽  
William J. Riggs ◽  
Michael S. Harris ◽  
Edward E Dodson
Keyword(s):  
Hair Cell ◽  
Vestibular Schwannoma ◽  
Cranial Nerve ◽  
Cell Activity ◽  
Internal Auditory Canal ◽  
Hearing Preservation ◽  
Healthy Patient ◽  
Cochlear Hair Cell ◽  
Translabyrinthine Approach ◽  
Cranial Nerve Viii

Objectives: To describe a case of inadvertent hearing preservation following a classical translabyrinthine resection of a vestibular schwannoma of the internal auditory canal in an otherwise healthy patient. Methods: Herein, we describe the case of an otherwise healthy patient who underwent resection of an intracanalicular vestibular schwannoma via a translabyrinthine approach. Furthermore, as part of an ongoing study aimed at characterizing hearing changes due to intraoperative events, cochlear hair cell and nerve activity were monitored using electrocochleography throughout surgery. Unexpectedly, the patient maintained serviceable hearing following surgery. As a result, we are able to provide electrophysiologic evidence of cochlear hair cell activity at various stages of this surgery. Results: Hair cell responses across tested frequencies were detectable prior to and following completion of the translabyrinthine procedure. Neural integrity of the auditory division of cranial nerve VIII was maintained throughout. Lastly, postoperative audiometric testing supported the patient’s subjective assertion of serviceable hearing in the surgical ear. Conclusion: Our results suggest that some degree of hair cell and neural integrity can be maintained throughout the course of the translabyrinthine approach, and if preservation of the auditory division of cranial nerve VIII is feasible, a functional amount of hearing preservation is attainable.

Hearing Preservation Using the Modified Translabyrinthine Approach

2015 ◽  
pp. 912-915
Author(s):  
John T. McElveen ◽  
Robert H. Wilkins ◽  
Ram Singh ◽  
David W. Molter ◽  
Andrea C. Erwin ◽  
...  
Keyword(s):  
Hearing Preservation ◽  
Translabyrinthine Approach

Hearing preservation after translabyrinthine approach performed to remove a large vestibular schwannoma

2008 ◽  
Vol 266 (1) ◽  
pp. 147-150 ◽  
Author(s):  
Stéphane Tringali ◽  
Chantal Ferber-Viart ◽  
Stéphane Gallégo ◽  
Christian Dubreuil
Keyword(s):  
Vestibular Schwannoma ◽  
Hearing Preservation ◽  
Translabyrinthine Approach ◽  
Large Vestibular Schwannoma

Criteria for hearing preservation in acoustic schwannoma surgery: The concept of useful hearing

1992 ◽  
Vol 106 (6) ◽  
pp. 500-503 ◽  
Author(s):  
A. E. Hinton ◽  
R. T. Ramsden ◽  
R. H. Lye ◽  
J. E. M. Dutton
Keyword(s):  
Pure Tone ◽  
Tumour Size ◽  
Hearing Preservation ◽  
Discrimination Score ◽  
Speech Discrimination ◽  
Average Difference ◽  
Pure Tone Audiogram ◽  
Speech Discrimination Score ◽  
Acoustic Schwannoma

AbstractIn the quest for hearing preservation in patients with acoustic schwannomas it is essential that surgeons do not lose sight of the concept of ‘useful’ hearing. There is an important difference between hearing preservation which pleases the surgeon and that which will be appreciated by the patient.Tumour size, pure tone audiogram average differences between ears and speech discrimination scores have been recorded in a series of 114 patients with unilateral acoustic schwannomas. Criteria for useful hearing are presented in terms of pure tone audiogram average difference and speech discrimination scores.There were 11 patients (10 per cent) with a speech discrimination score of 50 per cent or more, a pure tone audiogram average difference of 30 dB or better and a tumour size of no more than 2 cm. Only one patient (0.9 per cent) had a speech discrimination score of 50 per cent or more, a pure tone audiogram average difference of 20 dB or better and a tumour size of no more than 1 cm.It is concluded that hearing preservation techniques may be applicable to between 1 and 10 per cent of patients with unilateral acoustic schwannomas.

Modified Translabyrinthine Approach and Hearing Preservation

2004 ◽  
Vol 114 (6) ◽  
pp. 1133-1138 ◽  
Author(s):  
Giuseppe Magliulo ◽  
Donato Parrotto ◽  
Alessandro Stasolla ◽  
Mario Marini
Keyword(s):  
Hearing Preservation ◽  
Translabyrinthine Approach
Sign in / Sign up

Export Citation Format

Share Document