• Journal of Korean Neurosurgical Society
• /
• 제30권6호
• /
• pp.755-760
• /
• 2001

Objective : To determine the feasibility of translabyrinthine approach in the vestibular schwannoma patients, the authors reviewed eighteen consecutive cases, focusing at their functional outcome and operative complications. Materials and Method : To evaluate the functional outcome, we reviewed preoperative radiological findings such as size of tumors and location of jugular bulb as well as the preoperative neurological status including audiometric analysis and cranial nerve function in 18 patients, diagnosed as vestibular schwannoma. Also the surgical outcome was evaluated according to the functional preservation of facial nerve and incidence of the surgical complication as well as the extent of surgical resection. Results : The age of patients ranged from 21 to 62 years, with a mean of 50 years. Of 18 patients operated in our center by the translabyrinthine approach, wide exposure with total removal of the mass was possible in 16 cases (88.8%). The facial nerve was anatomically preserved in 88.8%. At six-month follow-up, facial nerve function was good(Grade I-II) in 15 patients(83%) and acceptable(I-IV) in all patients. Although the jugular bulb was highly placed is five patients, gross total resection was possible without facial nerve injury in all patients by the translabyrinthine approach. One patient experienced CSF leakage after surgery, but there was no patient with disabling deficit. Conclusion : Use of the translabyrinthine approach for removal of vestibular schwannomas resulted in good anatomical and functional preservation of the facial nerve, with minimal incidence of morbidity and no mortality. In cases of high jugular bulb impacted into mastoid bone, total removal was possible by displacing the jugular bulb with Surgicel cellulose and placement of bone wax.

• Journal of Korean Neurosurgical Society
• /
• 제43권1호
• /
• pp.57-60
• /
• 2008

The authors herein propose the staged excision as a novel strategy to preserve facial nerve and minimize complication during microsurgery of large vestibular schwannoma (VS). At the first stage, for reducing mass effect on the brain stem and cerebellum, subtotal tumor resection was performed via a retrosigmoid craniotomy without intervention of meatal portion of tumor. With total resection of the remaining tumor, the facial nerve was decompressed and delineated during the second stage translabyrinthine approach at a later date. A 38-year-old female who underwent the staging operation for resection of her huge VS is illustrated.

• Journal of Korean Neurosurgical Society
• /
• 제57권4호
• /
• pp.292-294
• /
• 2015

Vestibular schwannoma (VS) usually present the widening of internal auditory canal (IAC), and these bony changes are typically limited to IAC, not extend to temporal bone. Temporal bone invasion by VS is extremely rare. We report 51-year-old man who revealed temporal bone destruction beyond IAC by unilateral VS. The bony destruction extended anteriorly to the carotid canal and inferiorly to the jugular foramen. On histopathologic examination, the tumor showed typical benign schwannoma and did not show any unusual vascularity or malignant feature. Facial nerve was severely compressed and distorted by tumor, which unevenly eroded temporal bone in surgical field. Vestibular schwannoma with atypical invasion of temporal bone can be successfully treated with combined translabyrinthine and lateral suboccipiral approach without facial nerve dysfunction. Early detection and careful dissection of facial nerve with intraoperative monitoring should be considered during operation due to severe adhesion and distortion of facial nerve by tumor and eroded temporal bone.

• Journal of Korean Neurosurgical Society
• /
• 제44권4호
• /
• pp.268-272
• /
• 2008

Endolymphatic sac tumor is rare, locally aggressive hypervascular tumor of papillary structure, arising from the endolymphatic duct or sac in the posterior petrous bone. We present four cases with this tumor. Two patients were male and the other two were female. Age of each patient was 15, 52, 58, and 67 years. Three patients presented with progressive hearing loss and sustained vertigo for months to years and another one was referred for the tumor detected in routine medical check-up. Preoperative embolization was performed in 3 patients. Complete excision of the tumor was achieved in all patients using translabyrinthine or retrosigmoid approach. Herein, we describe the clinical and radiographic features, surgical treatment and pathologic findings with a review of the literature.