title: Acoustic schwannoma with intracochlear extension and primary intracochlear schwannoma: removal through translabyrinthine approach with facial bridge cochleostomy and transcanal approach.
abstract: Intracochlear schwannomas can occur either as an extension of a larger tumor from the internal auditory canal, or as a solitary labyrinthine tumor. They are currently removed via a translabyrinthine approach extended to the basal turn, adding a transotic approach for tumors lying beyond the basal turn. Facial bridge cochleostomy may be associated with the translabyrinthine approach to enable the whole cochlea to be approached without sacrificing the external auditory canal and tympanum. We describe seven cases, five of which underwent cochlear schwannoma resection with facial bridge cochleostomy, one case with the same procedure for a suspect tumor and one, previously subjected to radical tympanomastoidectomy, who underwent schwannoma resection via a transotic approach. Facial bridge cochleostomy involved removing the bone between the labyrinthine and tympanic portions of the fallopian canal, and exposing the cochlea from the basal to the apical turn. Patients' recovery was uneventful, and long-term magnetic resonance imaging showed no residual tumor. Facial bridge cochleostomy can be a flexible extension of the translabyrinthine approach for tumors extending from the internal auditory canal to the cochlea. The transcanal approach is suitable for the primary exclusive intralabyrinthine tumor. The indications for the different approaches are discussed.
authors.affiliation: Department of Neuroscience, Otolaryngology Unit, Padova University, via Giustiniani 2, 35128, Padova, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Mazzoni
authors.affiliation: Department of Neuroscience, Otolaryngology Unit, Padova University, via Giustiniani 2, 35128, Padova, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Zanoletti
authors.affiliation: Department of Neuroscience, Otolaryngology Unit, Padova University, via Giustiniani 2, 35128, Padova, Italy. facciolichiara@libero.it.
authors.forename: C
authors.initials: C
authors.lastname: Faccioli
authors.affiliation: Department of Neuroscience, Otolaryngology Unit, Padova University, via Giustiniani 2, 35128, Padova, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Martini
mesh_terms: D000328:Adult; D004210:Dissection / Q000009:adverse effects / Q000379:methods; D004424:Ear Canal / Q000601:surgery; D004428:Ear Neoplasms / Q000473:pathology / Q000601:surgery; D007758:Ear, Inner / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007558:Italy; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D018365:Neoplasm, Residual / Q000175:diagnosis / Q000517:prevention & control; D009442:Neurilemmoma / Q000473:pathology / Q000601:surgery; D009464:Neuroma, Acoustic / Q000473:pathology / Q000601:surgery; D013506:Otologic Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010043:Outcome and Process Assessment, Health Care; D012189:Retrospective Studies; D014432:Tympanic Membrane / Q000601:surgery
keywords: Facial bridge cochleostomy; Intracochlear schwannoma; Posterior labyrinthectomy; Translabyrinthine approach