title: Combined endoscope-assisted translabyrinthine subtemporal keyhole approach for vestibular Schwannoma and auditory midbrain implantation: Cadaveric study.
abstract: CONCLUSIONS
  The combined endoscope-assisted translabyrinthine subtemporal keyhole approach can expose the internal auditory canal, cerebellopontine, and inferior colliculus satisfactorily in the same surgical setting. As a minimally invasive approach, this can be considered an effective method for removal of vestibular schwannoma and auditory midbrain implantation in the same surgical setting, while avoiding retraction of the cerebellum and serious adverse events and complications.
  
  
  OBJECTIVE
  Patients with neurofibromatosis type II are the initial candidates for auditory midbrain implantation; the appropriate surgical approach should allow for tumor removal and electrode implantation in the same surgical setting. Here, we demonstrate the possibility of the combined endoscope-assisted translabyrinthine subtemporal keyhole approach to achieve this aim.
  
  
  METHODS
  Five formalin-fixed cadaver heads were used to simulate surgical procedures in 10 sides, by means of microscopy and endoscopy. The relationship between concerned structures was identified.
  
  
  RESULTS
  With the help of an endoscope, we exposed the internal auditory canal and cerebellopontine through a translabyrinthine approach and the inferior colliculus through a subtemporal keyhole approach. This double approach can be combined to expose the internal auditory canal and cerebellopontine and inferior colliculus satisfactorily in the same surgical setting. This combined approach can avoid retraction of the cerebellum and reduce serious adverse events and complications.
authors.affiliation: Department of Otolaryngology, Beijing Tongren Hospital, Capital Medical University, Ministry of Education, China.
authors.forename: Jia-Qiang
authors.initials: JQ
authors.lastname: Sun
authors.forename: De-Min
authors.initials: DM
authors.lastname: Han
authors.forename: Yong-Xin
authors.initials: YX
authors.lastname: Li
authors.forename: Shu-Sheng
authors.initials: SS
authors.lastname: Gong
authors.forename: Hong-Rui
authors.initials: HR
authors.lastname: Zan
authors.forename: Tong
authors.initials: T
authors.lastname: Wang
mesh_terms: D002102:Cadaver; D007758:Ear, Inner / Q000601:surgery*; D004567:Electrodes, Implanted; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D008636:Mesencephalon / Q000601:surgery*; D009464:Neuroma, Acoustic / Q000601:surgery*; D019635:Neurosurgical Procedures; D010579:Petrous Bone / Q000601:surgery