Expanded transcanal transpromontorial approach for vestibular schwannoma

• Published in: American journal of otolaryngology Vol. 43; no. 5; p. 103486
• Main Authors: Marchioni, Daniele, Caiazza, Nicole, Dallari, Virginia, Sacchetto, Andrea
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2022; Elsevier Limited
• Subjects: Agreements; Complications; Ear; Ear canal; Endoscopy; Ethical standards; Ethics; Facial nerve; Hearing loss; Informed consent; Internal auditory canal; Magnetic resonance imaging; Postoperative; Revisions; Schwann cells; Tinnitus; Transpromontorial approach; Tumors; Vestibular schwannoma; Vestibular system; Transpromontorial approach; Internal auditory canal; Endoscopy; Vestibular schwannoma; Hearing loss
• ISSN: 0196-0709; 1532-818X
• DOI: 10.1016/j.amjoto.2022.103486

The ExpTTA is a combined endoscopic and microscopic technique allowing direct access to internal auditory canal (IAC) and cerebellopontine angle (CPA) without extended bone removal, as required by the traditional approaches [3].2 Methods: case description A 28-year-old patient suffering from persistent dizziness, tinnitus and right hearing loss underwent magnetic resonance imaging, revealing a 10 mm lesion involving the IAC, increased up to 14 mm in 6 months. Through postauricolar incision, the superficial soft tissue is displaced to access the bony external auditory canal (EAC) after the removal of the skin. Six months later, he had no facial nerve deficit (grade I according to House-Brackmann scale), and no relevant post-operative complications were reported.4 Discussion The ExpTTA allows an extension of the anatomic limits of the endoscopic exclusive transcanal transpromontorial approach (EETTA) [4,5], a direct control of the tumor and neurovascular structures, easy control of bleeding and a reduction in surgical time when compared to EETTA.Ethical approval All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.Informed consent Informed consent was obtained from the participant included in the study.CRediT authorship contribution statement Daniele Marchioni, conception of the work, revision of work for important intellectual content, final approval of version to be published, agreement to be accountable for all aspects of work; Nicole Caiazza, revision of work for important intellectual content, final approval of the version to be published, agreement to be accountable for all aspects of work; Virginia Dallari, revision of work for important intellectual content, final approval, agreement to be accountable for all aspects of work; Andrea Sacchetto, revision of work for important intellectual content, final approval, agreement to be accountable for all aspects of work.Declaration of competing interest The present authors have no financial relationship to disclose.Appendix A Supplementary data The following is the supplementary data related to this article.Video 1description of the main surgical steps of ExpTTA for removal of vestibular schwannoma.Video 1Audio transcriptImage 1Appendix A Supplementary data Supplementary data to this article can be found online at https://doi.org/10.1016/j.amjoto.2022.103486.