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Intralabyrinthine schwannomas: a new surgical treatment

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objective

To define a new surgical option, with lower morbidity, for the treatment of intralabyrinthine schwannomas.

Study design

Retrospective case review.

Setting

Tertiary referral centers.

Patients

Eight patients affected by an intralabyrinthine schwannoma, with or without extension to the internal auditory canal, that underwent surgery with a transcanal transpromontorial approach, were included in the study. The average age at presentation was 47 years. Patients’ characteristics, symptoms, tumor features, and surgical results were analyzed.

Interventions

All patients were diagnosed and evaluated pre-operatively with high-resolution, gadolinium-enhanced MRI and CT scan of the temporal bone, and underwent surgery via either transcanal transpromontorial endoscopic approach (TTEA) or enlarged transcanal transpromontorial endoscopic approach (ETTA).

Main outcome measures

Hearing function was evaluated with the Hearing Classification System according to the Committee on Hearing and Equilibrium Guidelines. Facial nerve function was evaluated using the House–Brackmann grading system (HB).

Results

In six patients out of eight, a TTEA was performed, whereas, due to the extension of the pathology to the cerebellopontine angle, two patients underwent an ETTA. The mean follow-up period was 15.5 months (range 1–69). No intra-operative and post-operative major complications were observed. Post-operative facial nerve function was normal in seven out of eight patients (grade I HB). One patient presented a grade II HB.

Conclusion

The endoscopic approach to cochlear schwannoma represents a good treatment option for patients and should be preferred to other more invasive surgical techniques when indicated, to reduce complications, hospitalization, and offer to patients the chance to eradicate the disease, thus avoiding the stress of a long-life radiological follow-up.

Level of evidence

4.

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Funding

The present authors have no financial relationship to disclose.

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Authors and Affiliations

  1. Otolaryngology-Head and Neck Surgery Department, University Hospital of Verona, Piazzale Aristide Stefani, 1, 37126, Verona, Italy

    Daniele Marchioni, Stefano De Rossi, Davide Soloperto, Luca Sacchetto & Alessia Rubini

  2. Otolaryngology-Head and Neck Surgery Department, University Hospital of Modena, via del Pozzo, 71, 41124, Modena, Italy

    Livio Presutti

Authors
  1. Daniele Marchioni
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  2. Stefano De Rossi
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  3. Davide Soloperto
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  4. Livio Presutti
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  5. Luca Sacchetto
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  6. Alessia Rubini
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Contributions

All of the authors have read and approved the manuscript.

Corresponding author

Correspondence to Stefano De Rossi.

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Conflict of interest

None of the authors has conflicts of interest to declare.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Marchioni, D., De Rossi, S., Soloperto, D. et al. Intralabyrinthine schwannomas: a new surgical treatment. Eur Arch Otorhinolaryngol 275, 1095–1102 (2018). https://doi.org/10.1007/s00405-018-4937-0

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  • DOI: https://doi.org/10.1007/s00405-018-4937-0

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