Preliminary Application of Modified Transotic Approach in Acoustic Neuroma Surgery

Objective: To investigate the preliminary effect of refined transotic approach in acoustic neuroma surgery.

Methods: The clinical data of 16 patients with acoustic neuroma who underwent modified transotic approach during the period from March 2017 to August 2018 were enrolled into this retrospective study. Intracranial hemorrhage was excluded in 6 hours postoperatively by cranial CT, and MRI was performed to observe the residual tumor 1 week postoperatively. The facial nerve function that evaluated according to the House–Brackmann (HB) classification system of all the patients was followed up at the outpatient department.

Results: The radical tumor resection rate was 100%. The facial nerve structure preservation rate was 100%. According to the results of CT and MRI examinations, there were no intracranial hemorrhage occurred and residual tumor in all patients. After surgery, all patients were single—side deaf. Nine patients (56.3%) experienced vertigo, which was relieved after treatment. There was no cerebrospinal fluid leakage and other severe complication such as intracranial infection, hemiplegia, or death. All patients were followed up for 2 weeks to 17 months, with an average of (17.25 + 6.28) weeks. Facial nerve function after surgery was assessed by the HB classification system, five patients(31.3%) were grade I, nine patients(56.3%) were grade II, one patient (6.2%) was grade III, one patient (6.2%) was grade IV.

Conclusion: Refined transotic approach has the advantages of both the translabyrinthine approach and transotic approach, which can achieve radical removal of tumor on the basis of intact cochlear structure, at the same time it can achieve preservation of facial nerve and reduction of cerebrospinal fluid leakage and other intracranial complications.

No conflict of interest has been declared by the author(s).