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Endoscopic-Assisted Keyhole Middle Cranial Fossa Approach for Small Vestibular Schwannomas

Authors
 In Seok Moon  ;  Ick Soo Choi  ;  Seung Ho Shin  ;  Seungjoon Yang  ;  Youngrak Jung  ;  Gina Na 
Citation
 JOURNAL OF CLINICAL MEDICINE, Vol.11(9) : 2324, 2022-04 
Journal Title
JOURNAL OF CLINICAL MEDICINE
Issue Date
2022-04
Keywords
endoscope ; middle cranial fossa ; minimally invasive ; vestibular schwannoma
Abstract
The classical middle cranial fossa approach (MCFA) for vestibular schwannoma (VS) removal often requires a large incision and craniotomy, excessive temporal lobe manipulation, and a longer recovery. We describe a keyhole MCFA (KMCFA) with endoscopic assistance that allows for adequate access with minimal temporal lobe manipulation, resulting in a fast recovery and an invisible scar. Eight sides of four cadaveric heads were dissected through the endoscopic-assisted KMCFA to access the internal auditory canal (IAC). Furthermore, five patients with intracanalicular VS underwent tumor removal with the endoscopic-assisted KMCFA. During the endoscopic-assisted KMCFA with fine instruments, a 3-cm supra-auricular incision and a 2-cm diameter keyhole craniotomy achieved exposure of the entire length of the IAC in all cadaveric dissections without unintended violation of the cochlea, semicircular canal, and facial nerve. The gross tumor was totally removed in five patients with no major postoperative complications. The surgical time was reduced, the hearing outcomes were similar to those of the classical MCFA, and the scar was invisible 1 month after the surgery. The endoscopic-assisted KMCFA permits intracanalicular VS removal in a safe, efficient, and cosmetic way. For small intracanalicular VSs, this approach can replace the classical MCFA when indicated.
Files in This Item:
T202205013.pdf Download
DOI
10.3390/jcm11092324
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
Yonsei Authors
Na, Gina(나지나)
Moon, In Seok(문인석) ORCID logo https://orcid.org/0000-0002-3951-5074
Shin, Seung Ho(신승호) ORCID logo https://orcid.org/0000-0001-9352-8426
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191358
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