Retrolabyrinthine approach for cerebellopontine angle region surgeries / 中国耳鼻咽喉头颈外科

OBJECTIVE To evaluate the application ofretrolabyrinthine approach in cerebellopontine angel(CPA) region surgeries.METHODS A total of 42 patients underwent microscopic-endoscopic cooperative surgeries for CPA lesions via retrolabytinthine approach were reviewed.They were hospitalized from January 1st 2011 to January 1st 2016 in our institution.The microscopic-endoscopic technique was applied in all surgeries.RESULTS Complete removal was obtained in all tumor resections and satisfactory symptom-relief was achieved in all microvascular decompressions and neurectomies.In cases with acoustic neuroma and cholesteatoma,useful hearing (AAO-HNS classes A,B and C) was obtained in 66.7％(6/9) patients.No facial paralysis and postoperative complications such as cerebrospinal fluid leakage occurred during follow-up.In cranial nerve rhizopathies cases,complete relief was achieved in all patients.No facial paralysis and other lower cranial nerve dysfunction occurred.CONCLUSION With the preservation of labyrinthine structures,the microscopic-endoscopic cooperative surgeries for CPA lesions via retrolabytinthine approach could increase the hearing preservation level without facial nerve injury.Retrolabyrinthine approach is a good option for cranial nerve rhizopathies and tumors smaller than 15 mm in diameter without involvement of the fundus of internal auditory canal in the CPA region.

Vestibular Neurectomy in the Treatment of Intractable Peripheral Vertigo: Case Report

Vestibular neurectomy is known as an effective procedure in the management of intractable peripheral vertigo from Meniere's disease and other episodic peripheral vertigo disorders. Various approaches have been developed for selectively sectioning the vestibular nerve, in order to preserve hearing and avoid facial nerve injury. Vestibular neurectomy is performed in two patients with Meniere's disease to control intractable episodic vertigo through retrolabyrinthine approach. Vertigo was improved with preserving their hearing. We report the surgical technique and advantages of retrolabyrinthine vestibular neurectomy in the treatment of vertigo.