Expanded transcanal transpromontorial approach for acoustic neuroma removal.

Laryngoscope

Department of Otolaryngology - Head and Neck Surgery, Azienda Ospedaliero-Universitaria Policlinico di Modena, University of Modena and Reggio Emilia, Modena, Italy.

Published: February 2023

Axial sections from preoperative magnetic resonance imaging without contrast, showing a cone-shaped lesion of the internal auditory canal, extending toward the most lateral part of the cerebello-pontine angle. (A) T1-weighted high-resolution isotropic volume excitation (THRIVE) sequence; (B) T1-weighted sequence; (C) Fluid attenuated inversion recovery (FLAIR) sequence. Laryngoscope, 133:282-286, 2023.

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http://dx.doi.org/10.1002/lary.30281DOI Listing

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Article Synopsis
  • The study investigates the use of augmented reality (AR) in transcanal endoscopic ear surgery (TEES) for middle ear cholesteatoma, especially in cases with mastoid extension.
  • It finds that predictability for the extent of external auditory canal (EAC) removal is improved with AR technology, differentiating between cases needing extensive versus minimal EAC resection.
  • The results may guide whether to use TEES or a canal wall-up mastoidectomy, ultimately aiming to enhance surgical outcomes and pave the way for future robotic surgeries.
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Transcanal transpromontorial approach for vestibular schwannoma: experience of a single center.

Eur Arch Otorhinolaryngol

May 2024

Posterior Cranial Fossa Unit, Department of Neurosciences, Biomedicine and Movement Sciences, Ospedale Civile Maggiore Verona, Verona, Italy.

Background: The expanded transpromontorial transcanal approach (ExpTTA) represents a recent addition to the surgical approaches available for the treatment of vestibular schwannoma. An initial purely endoscopic version has been complemented by the use of the microscope and it is now one of the possible surgical options for small to medium-sized vestibular schwannomas with a predominantly intracanalar development.

Methods: This is a series of 54 patients who underwent microsurgical resection of sporadic, unilateral vestibular schwannoma, mainly Koos I-II with non-serviceable hearing, between January 2016 and January 2023 using the expanded transcanal transpromontorial approach.

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Purpose: A variety of lesions could arise from the GG area, or extend into this region from adjacent sites. The management of perigeniculate lesions includes observation, surgery, and radiation, according to the nature, the size of the lesion, and the accompanying symptoms. Preliminary experiences on the exclusive transcanal endoscopic approach to the GG area have shown safety and feasibility avoiding of any postauricular incision, or brain manipulation.

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Objective: Exclusive endoscopic (EETTA) and expanded (ExpTTA) transcanal transpromontorial approaches have shown promising results for treating internal auditory canal (IAC) lesions. We reviewed the literature to answer the question: "Do EETTA and ExpTTA achieve high rates of complete resection and low rates of complications in treating patients with IAC pathologies?"

Data Sources: PubMed, EMBASE, Scopus, Web of Science, and Cochrane were searched.

Review Methods: Studies reporting EETTA/ExpTTA for IAC pathologies were included.

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Background: Transcanal endoscopic surgery offers advantages for congenital cholesteatoma (CC) which is expanding cystic mass located on an intact tympanic membrane.

Objectives: To determine the efficacy of transcanal endoscopic ear surgery for the treatment of CC.

Material And Methods: Eleven patients with CC confined to the middle ear underwent transcanal endoscopic ear surgery by surgeons who were skilled in otoscopic surgery.

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