Department of Otolaryngology-Head and Neck Surgery, Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
Ear Institute, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Eur Arch Otorhinolaryngol. 2022 Jan;279(1):75-82. doi: 10.1007/s00405-021-06612-z. Epub 2021 Feb 1.
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.
评估显微镜辅助内镜经耳道经岩骨前入路（METTA）切除局限于内听道（IAC）的小前庭神经鞘瘤（VS）的可行性，并介绍一种无需外耳道（EAC）关闭的改良方法。
2018 年 8 月至 2019 年 2 月，我中心对 7 例内耳道 VS 患者进行了手术治疗，前 2 例采用内镜经耳道经岩骨前入路，其余 5 例采用 METTA 进行手术。记录并分析了包括肿瘤切除效果、面神经功能、手术时间和术后过程在内的治疗结果。
7 例患者均经病理证实为内耳道 VS。所有病例均达到全切除肿瘤。2 例患者出现脑脊液漏，5 天内自行缓解。平均手术时间为 161.41±18.42 分钟。所有患者术后 1 个月面神经功能正常。
METTA 在外耳道 VS 的切除中是有效的。对于无功能听力的内耳道 VS，它可以作为一种替代的手术选择。
