The extracisternal approach in vestibular schwannoma surgery and facial nerve preservation

The classical surgical technique for the resection of vestibular schwannomas (VS) has emphasized the microsurgical anatomy of cranial nerves. We believe that the focus on preservation of the arachnoid membrane may serve as a safe guide for tumor removal. Method: the extracisternal approach is descri...

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Detalles Bibliográficos
Autores: Vellutini, Eduardo A. S., Beer-Furlan, Andre, Brock, Roger S., Gomes, Marcos Q. T., Stamm, Aldo, Cruz, Oswaldo Laercio M. [UNIFESP]
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2014
País:Brasil
Institución:Universidade Federal de São Paulo (UNIFESP)
Repositorio:Repositório Institucional da UNIFESP
Idioma:inglés
OAI Identifier:oai:repositorio.unifesp.br:11600/38484
Acceso en línea:http://dx.doi.org/10.1590/0004-282X20140152
http://repositorio.unifesp.br/handle/11600/38484
Access Level:acceso abierto
Palabra clave:arachnoid membrane
facial nerve
surgery
vestibular schwannoma
acoustic neurinoma
Descripción
Sumario:The classical surgical technique for the resection of vestibular schwannomas (VS) has emphasized the microsurgical anatomy of cranial nerves. We believe that the focus on preservation of the arachnoid membrane may serve as a safe guide for tumor removal. Method: the extracisternal approach is described in detail. We reviewed charts from 120 patients treated with this technique between 2006 and 2012. Surgical results were evaluated based on the extension of resection, tumor relapse, and facial nerve function. Results: Overall gross total resection was achieved in 81% of the patients. the overall postoperative facial nerve function House-Brackmann grades I-II at one year was 93%. There was no recurrence in 4.2 years mean follow up. Conclusion: the extracisternal technique differs from other surgical descriptions on the treatment of VS by not requiring the identification of the facial nerve, as long as we preserve the arachnoid envelope in the total circumference of the tumor.