CC BY-NC-ND 4.0 · J Neurol Surg B 2018; 79(S 05): S387-S388
DOI: 10.1055/s-0038-1669971
Skull Base: Operative Videos
Georg Thieme Verlag KG Stuttgart · New York

Microsurgical Gross Total Resection of a Large Residual/Recurrent Vestibular Schwannoma via Translabyrinthine Approach

Sima Sayyahmelli
1  Department of Neurological Surgery, University of Wisconsin Medical School, Madison, Wisconsin, United States
,
Joseph Roche
1  Department of Neurological Surgery, University of Wisconsin Medical School, Madison, Wisconsin, United States
,
Mustafa K. Baskaya
1  Department of Neurological Surgery, University of Wisconsin Medical School, Madison, Wisconsin, United States
› Author Affiliations
Disclosure of Funding None.
Further Information

Address for correspondence

Mustafa K. Baskaya, MD
Department of Neurological Surgery, University of Wisconsin Medical School
K4/834 CSC, 600 Highland Avenue, Madison, WI 53792-0001
United States   

Publication History

31 May 2018

12 August 2018

Publication Date:
25 September 2018 (eFirst)

 

    Abstract

    Although, gross total resection in large vestibular schwannomas is an ideal goal, subtotal resection is frequently performed due to lack of expertise, concerns for facial palsy, or overuse of stereotactic radiation. In this video, we present a 31-year-old man with a 7-year history of tinnitus, dizziness, and hearing loss. The patient had a subtotal resection of a 2.5 cm right-sided vestibular schwannoma via retrosigmoid craniotomy at an outside hospital. He was referred for further surgical resection due to the increased size of the tumor on surveillance magnetic resonance imagings (MRIs) and worsening symptoms. MRI showed a residual/recurrent large schwannoma with extension to the full length of the internal acoustic canal and brain stem compression. He underwent microsurgical gross total resection via a translabyrinthine approach. The facial nerve was preserved and stimulated with 0.15 mA at the brainstem entry zone. He awoke with House–Brackmann grade III facial function, with an otherwise uneventful postoperative course. In this video, microsurgical techniques and important resection steps for this residual/recurrent vestibular schwannoma are demonstrated, and nuances for microsurgical technique are discussed.

    The link to the video can be found at: https://youtu.be/a0ZxE41Tqzw.


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    Zoom Image
    Fig. 1 Pre and postoperative magnetic resonance imaging.
    Zoom Image
    Fig. 2 Intraoperative images.

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    Quality:

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    Conflict of Interest

    None.

    Address for correspondence

    Mustafa K. Baskaya, MD
    Department of Neurological Surgery, University of Wisconsin Medical School
    K4/834 CSC, 600 Highland Avenue, Madison, WI 53792-0001
    United States   

      
    Zoom Image
    Fig. 1 Pre and postoperative magnetic resonance imaging.
    Zoom Image
    Fig. 2 Intraoperative images.