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No1(1) 2018

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DOI 10.37219/2528-8253-2018-1-40
Palamar O.I., Huk A.P., Okonskyi D.I., Aksyonov R.V., Teslenko D.S.
Spreading of the vestibular schwannoma into porus acusticus internus. Endoscopic removal possibilities   
Palamar Orest I.
State Institution “Romodanov Neurosurgery Institute of Neurosurgery National Academy of Medical Sciences of Ukraine”
PhD
https://orcid.org/0000-0003-1806-9463

Huk Andriy P.
State Institution “Romodanov Neurosurgery Institute of Neurosurgery National Academy of Medical Sciences of Ukraine”
Head of Department Endoscopy and Craniofacial Neurosurgery with a Group of Adjuvant Treatment
PhD
https://orcid.org/0000-0002-2754-7570

Okonskyi Dmytro I.
State Institution “Romodanov Neurosurgery Institute of Neurosurgery National Academy of Medical Sciences of Ukraine”; Kyiv, Ukraine
Neurosurgeon
E-mail: dr.okonskiy@ukr.net
https://orcid.org/0000-0002-7315-1833

Aksyonov Ruslan
State Institution “Romodanov Neurosurgery Institute of Neurosurgery National Academy of Medical Sciences of Ukraine”
E-mail: aksyonovrv@gmail.com
https://orcid.org/0000-0003-3744-6172

Teslenko Dmytro
State Institution “Romodanov Neurosurgery Institute of Neurosurgery National Academy of Medical Sciences of Ukraine”
https://orcid.org/0000-0001-5882-641X

Abstract

Aim: To investigate the features of the vestibular schwannoma spread into the internal auditory canal and the possibilities of endoscopic removal.
Objectives: To improve tumor visualization in the internal auditory canal; to create a sufficient view angle for tumor removal during endoscopic opening of the internal auditory canal.
Materials and methods: The results of surgical treatment of 20 patients with vestibular schwannomas in which the tumor spread to the internal auditory canal were analyzed. Microsurgical tumor removal was performed in 14 cases;
Fully endoscopic removal of vestibular schwannomas was performed in 6 cases. The internal auditory canal opening was performed in 14 cases using microsurgical technique and in 6 cases with fully the endoscopic technique.
Results: Gross total removal was achieved in 18 cases, subtotal removal in 2 cases. The tumor spread into the internal auditory canal was removed in all cases (100%). Opening the internal auditory canal using the endoscopic technique allows to increase the view angle (up to 20%) and to visualize along the axis of canal.
Conclusions: 1) Endoscopic assistance technique allows to improve residual tumor visualization much more better then microsurgical technique; 2) Internal auditory canal opening using endoscopic technique is much more effective than the microsurgical technique (trepanning depth is larger); 3) Endoscopic methods for the internal auditory canal opening allows to increase canal angle view up to 20% (comparing to the microsurgical view).

Keywords

Vestibular schwannomas, vestibular schwannomas spread into internal auditory canal, endoscopic removal of the vestibular schwannomas.


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