Transmastoid partial labyrinthectomy for brainstem vascular lesions: clinical outcomes and assessment of postoperative cochleovestibular function.
OBJECTIVE
To discuss the transmastoid partial labyrinthectomy approach for brainstem vascular lesions, with respect to hearing and balance preservation.


METHODS
Retrospective case series.


METHODS
Tertiary referral center (University Health Network, Toronto).


METHODS
Nine consecutive surgical patients between 1999 and 2004.


METHODS
Clinical, audiometric, and electrophysiological vestibular data.


RESULTS
Nine transmastoid partial labyrinthectomy procedures (all females) were performed. In seven patients the underlying pathology was an intra-axial brainstem cavernous malformation. Two patients were treated for a basilar artery aneurysm. All patients had progressive neurological signs. Serviceable hearing (pure tone average (PTA): < 50 dB; speech discrimination score (SDS): > 50%) was preserved in seven patients. Partial vestibular function (clinical and electrophysiological) was maintained in most patients.


CONCLUSIONS
The partial labyrinthectomy approach to the skull base provides excellent exposure while preserving cochleovestibular function in most patients.
Taplin
Michael A
MA
Department of Otolaryngology, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Anthony
Richard
R
Tymianski
Michael
M
Wallace
Michael C
MC
Rutka
John A
JA