A microscope-assisted endoscopic transcanal transpromontorial approach for vestibular schwannoma resection: a preliminary report



To evaluate the feasibility of a microscope-assisted endoscopic transcanal transpromontorial approach (METTA) for the removal of small vestibular schwannomas (VS) limited to the internal auditory canal (IAC), and introduce a modification without external auditory canal (EAC) closure.


Between August 2018 and February 2019, seven patients with intrameatal VS underwent surgery in our center, endoscopic transcanal transpromontorial approach was applied in the first 2 patients and the rest 5 patients were operated via METTA. Treatment outcomes including efficacy of tumor resection, facial nerve outcome, operation time and post-operative course were recorded and analyzed.


All seven patients were pathologically confirmed to have intrameatal VS. Total tumor removal was achieved in all cases. Two patients experienced cerebrospinal fluid leakage which resolved spontaneously within 5 days. The average operation time was 161.41 ± 18.42 min. All patients presented normal facial nerve function 1 month after surgery.


The METTA was effective in the removal of intrameatal VS. It can be an alternative surgical option for intrameatal VS with no serviceable hearing.

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This research was supported by grants from “Star of Jiaotong University” program of Shanghai Jiaotong University (YG2019QN) and “Technology Innovation Action Plan” of Shanghai Science and Technology Commission (17441902800).

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CJ and CY contributed equally to this work.

Corresponding authors

Correspondence to Wang Zhaoyan or Wu Hao.

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The authors declare that they have no conflicts of interests.

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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.

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The datasets used or analysed during the current study are available from the corresponding author on reasonable request.

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Jianqing, C., Yongchuan, C., Zhihua, Z. et al. A microscope-assisted endoscopic transcanal transpromontorial approach for vestibular schwannoma resection: a preliminary report. Eur Arch Otorhinolaryngol (2021). https://doi.org/10.1007/s00405-021-06612-z

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  • Intrameatal
  • Vestibular schwannoma
  • Endoscopic
  • Microscope