Endoscope-assisted lateral skull base surgery / 中国医师进修杂志

ABSTRACT

Objective To explore the therapeutic efficacy and complications of endoscope-assisted lateral skull base surgery. Methods Assisted by hard-tube ear endoscope, 11 patients with acoustic neuroma were operated via labyrinthine approach and retrosigmoid approach, and 5 patients with petrous apex cholesteatoma were operated via middle cranial fossa approach and mastoid-middle cranial fessa approach. Results Among 11 patients with acoustic neuroma, total removal was achieved in 9 cases (81.8%), subtotal in 2 cases (18.2%). Facial nerves and cochlear nerves were preserved completely during operation. After operation there was no facial paralysis in 9 cases (81.8%), mild peripheral facial paralysis in 2 cases (18.2%), the same hearing level as that of preoperation in 2 patients (18.2%), hearing impairment in different degrees in 9 cases (81.8%), among which moderate sensorinural hearing loss in 1 patient (9.1%), moderate to severe in 2 patients (18.2%), severe in 3 patients (27.3%), profound in 3 patients (27.3%). Among 5 patients with petrous apex cholesteatoma, total removal was achieved in all cases. After operation, preoperative facial paralysis in 3 patients disappeared within 9 months, and moderate to severe conduction deafness appeared in 2 patients. Conclusions The application of ear endoscope in lateral skull base surgery can improve the total removal of lesions and the salvage rate of vessels and nerves. However, its disadvantages make it only be an assistant method for micresurgery.