Department of Otolarynoglogy-Head and Neck Surgery.
Department of Neurosurgery, University of Cincinnati Medical Center.
Otol Neurotol. 2019 Jan;40(1):114-120. doi: 10.1097/MAO.0000000000002035.
Evaluate the safety and efficacy of the ultrasonic bone aspirator (UBA) during middle cranial fossa (MCF) approach to vestibular schwannoma (VS).
Retrospective case series.
Tertiary referral center.
Charts of 192 consecutive VS patients over 18 years of age were reviewed to identify 65 patients who underwent MCF approach to VS resection between 2006 and 2017. A combination of UBA and high-speed drill (HSD) was used to decompress the internal auditory canal (IAC) in 25 patients and HSD alone was used in the other 40 patients.
INTERVENTION(S): Use of UBA during vestibular schwannoma surgery via MCF approach for decompression of the IAC.
MAIN OUTCOME MEASURE(S): Postoperative facial nerve outcomes assessed by the House-Brackmann (HB) facial nerve grading scale. Rates of gross total resection (GTR) and cerebrospinal fluid (CSF) leak.
There were no significant differences in postoperative facial nerve function, in rate of GTR of tumor, or in rate of CSF leak. In the UBA group 24/25 (96%) had postoperative HB grade I-II compared with 36/40 (90%) in the HSD group (p-value = 0.66). GTR was achieved in 25/25 (100%) in the UBA group compared with 38/40 (95%) in the HSD group (p-value = 1). In the UBA group, there were 0/25 (0%) cases of CSF leak compared with 1/40 (2.5%) in the HSD group (p-value = 1).
UBA use is a safe and effective alternative or adjunct to HSD during MCF approach to expose the IAC contents. This surgical tool allows for bone removal with low risk of injury to adjacent structures.
评估超声骨吸引器（UBA）在中颅窝（MCF）入路听神经瘤（VS）切除术中的安全性和有效性。
回顾性病例系列研究。
三级转诊中心。
回顾了 192 例年龄超过 18 岁的 VS 患者的图表，以确定 65 例 2006 年至 2017 年间接受 MCF 入路 VS 切除术的患者。25 例患者采用 UBA 和高速钻（HSD）联合减压内听道（IAC），40 例患者仅采用 HSD。
在 MCF 入路听神经瘤手术中使用 UBA 对内听道进行减压。
术后 House-Brackmann（HB）面神经分级量表评估面神经功能。大体全切除（GTR）率和脑脊液（CSF）漏率。
术后面神经功能、肿瘤 GTR 率和 CSF 漏率无显著差异。在 UBA 组，25/25（96%）例术后 HB 分级 I-II 级，HSD 组 36/40（90%）例（p 值=0.66）。UBA 组 25/25（100%）例达到 GTR，HSD 组 38/40（95%）例（p 值=1）。UBA 组 0/25（0%）例发生 CSF 漏，HSD 组 1/40（2.5%）例（p 值=1）。
在 MCF 入路暴露 IAC 内容物时，UBA 的使用是 HSD 的安全有效的替代或辅助方法。这种手术工具可以在不损伤相邻结构的情况下安全地去除骨。
