title: Endoscopic Resection of Vestibular Schwannomas.
abstract: Objective To report our results and the technical details of fully endoscopic resection of vestibular schwannomas. Design Prospective observational study. Setting A single academic institution involving neurosurgery and neurotology. Participants Twelve consecutive patients who underwent fully endoscopic resection of a vestibular schwannoma. Main Outcome Measures Hearing preservation, based on the American Association of Otolaryngology-Head and Neck Surgeons (AAO-HNS) score as well as the Gardener and Robertson Modified Hearing Classification (GR). Facial nerve preservation based on the House-Brackmann (HB) score. Results All patients successfully underwent gross total resection. Facial nerve preservation rate was 92% with 11 of 12 patients retaining an HB score of 1/6 postoperatively. Hearing preservation rate was 67% with 8 of 12 patients maintaining a stable AAO-HNS grade and GR score at follow-up. Mean tumor size was 1.5 cm (range: 1-2 cm). No patients experienced postoperative cerebrospinal fluid leak, infection, or cranial nerve palsy for a complication rate of 0%. Mean operative time was 261.6 minutes with an estimated blood loss of 56.3 mL and average length of hospital stay of 3.6 days. Conclusion A purely endoscopic approach is a safe and effective option for hearing preservation surgery for vestibular schwannomas in appropriately selected patients.
authors.affiliation: Section of Neurosurgery, St John Providence Health System, Michigan State Unviersty, Southfield, Michigan, United States.
authors.forename: Pradeep
authors.initials: P
authors.lastname: Setty
authors.affiliation: Section of Neurosurgery, St John Providence Health System, Michigan State Unviersty, Southfield, Michigan, United States.
authors.forename: Kenneth P
authors.initials: KP
authors.lastname: D'Andrea
authors.affiliation: Department of Neurotology, Michigan Ear Institute, Farmington Hills, Michigan, United States.
authors.forename: Emily Z
authors.initials: EZ
authors.lastname: Stucken
authors.affiliation: Department of Neurotology, Michigan Ear Institute, Farmington Hills, Michigan, United States.
authors.forename: Seilesh
authors.initials: S
authors.lastname: Babu
authors.affiliation: Department of Neurotology, Michigan Ear Institute, Farmington Hills, Michigan, United States.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: LaRouere
authors.affiliation: Department of Neurosurgery, Oakland University William Beaumont School of Medicine, Royal Oak, Michigan, United States.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Pieper
keywords: acoustic neuroma; cerebellopontine angle; endoscopy; skull base; vestibular schwannoma