Middle Cranial Fossa Approach. Our Initial Experience withExtirpation of Intracanalicular Vestibular Schwannomas by this Approach
J. Mrázek; T. Paleček; T. Hrabec
Klinika ORL a chirurgie hlavy a krku FNsP Ostrava, přednosta doc. MUDr. J. Mrázek, CSc. Neurochirurgická klinika FNsP Ostrava, přednosta MUDr. T. Paleček
Otorinolaryng. a Foniat. /Prague/, , 2001, No. 3, pp. 144-147.
Even the most careful mode of extirpation of a vestibular schwannoma by theextended middle cranial fossa approach (subtemporal extradural) has its pitfalls. The authorsdescribe two cases of the lateral variant of a tumour filling the inner auditory meatus, originatingfrom the lower vestibular branch with caloric normoflexion in the ENG image. In the first case thepreoperative hearing threshold was normal however without any response in the BERA tracing,with the temporal bone extremely pneumatized ending by postoperative deafness. In the secondcase the preoperative hearing was acceptable the V wave was, as compared with the sound side,delayed by 0.5 ms and the temporal bone lacked any pneumatization. Hearing was preserved at thepreoperative level. The authors describe technical problems with which the surgeon must copeunder these conditions and discuss prognostic factors which could influence the surgeon’s andpatient’s decision as regards surgical intervention.
vestibular schwannoma, extended middle fossa approach.
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