gms | German Medical Science

82. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e. V.

01.06. - 05.06.2011, Freiburg

Video-assisted microsurgical treatment of vestibular schwannoma

Meeting Abstract

  • corresponding author Martin Chovanec - Dep. of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, 150 06, Czech Republic
  • Jan Betka - Dep. of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Prague, Czech Republic
  • Eduard Zverina - Dep. of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Prague, Czech Republic
  • Jan Kluh - Dep. of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Prague, Czech Republic
  • Oliver Profant - Dep. of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Prague, Czech Republic
  • Petr Lukes - Dep. of Otorhinolaryngology and Head and Neck Surgery, 1st Faculty of Medicine, Prague, Czech Republic
  • Josef Kraus - Dep. of Pediatric Neurology, 2nd Faculty of Medicine, Charles University, Prague, Czech Republic

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 82. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Freiburg i. Br., 01.-05.06.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11hnod313

doi: 10.3205/11hnod313, urn:nbn:de:0183-11hnod3132

Veröffentlicht: 19. April 2011

© 2011 Chovanec et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Video-assisted microsurgery represents modern trend of vestibular schwannoma (VS) treatment. Of the newly diagnosed 149 patients with VS 80 patients have undergone retrosigmoid microsurgical removal during 2007–2009. Video-assisted microsurgical (VA-MS) removal was performed in 37 cases (Koos grade I: 1, grade II: 6, grade III: 10, grade IV: 20) and microsurgical (MS) removal was performed in 43 cases (grade I: 1, grade II: 2, grade III: 7, grade IV: 33). The most common complication was CSF-epidural pseudocyst (35% in both groups) that was managed conservatively. Neither mortality nor infection occured. Despite all cases in MS group were deemed as radically removed among 8% of cases in VA-MS group we identified residual tumors intrameatally not observed by the microscope only and were radicalized. Furthermore potential CSF-leaks were identified in 2 patients with no postoperative CSF-leak in the VA-MS group (54% in the MS group). In the VA-MS group excellent or very good (House-Brackmann 1 or 2) facial nerve function was achieved in 97% while poor function (House-Brackmann ≥ 4) was observed in 3% postoperatively. In the MS group excellent or very good facial nerve function was achieved in 53%, good (House-Brackmann 3) in 28% and poor function in 2% postoperatively. Better cochlear nerve preservation rate (52 vs. 28%), hearing preservation (45 vs. 10%) and useful hearing preservation – AAO-HNS class A, B (53 vs. 17%) were achieved in the VA-MS group. Adjunctive use of endoscope during VS surgery seems promising for assessment of radicality of resection and to decrease incidence of postoparative complications. Improving the information about critical structures and tumor itself helps to improve facial nerve and hearing results.

Supported by: IGA MZ CR NS/9909–3