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 VIDEO SECTION-OPERATIVE NUANCES: STEP BY STEP
Year : 2021  |  Volume : 69  |  Issue : 3  |  Page : 578--581

Endoscopic-Assisted Microsurgery for Vestibular Schwannomas: Operative Nuances


1 Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India
2 Department of ENT, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
3 Former Dean and Professor of Neurosurgery, Sree Chitra Tirunal Insitute of Medical Sciences, Trivandrum, Kerala, India

Correspondence Address:
Dr. Adesh Shrivastava
Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh 462020
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.319208

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Vestibular schwannoma surgery is a challenging operative procedure. Intricate anatomy of vital neurovascular structures demands a meticulous planning and execution. The cerebellopontine angle is an unforgiving area of skull bases surgery which can have grave implications on patient outcome even after a successful tumor removal. As more and more tumors are being detected at early stage, functional preservation of seventh and eighth nerve complex is increasingly being demanded. The key to any minimally invasive approach is to minimize the collateral damage while ensuring complete tumor removal. Binocular microscopy is the workhorse for illumination and dissection via retrosigmoid approach. However, as instrumentation has improved, endoscopic dissections are increasingly being performed. The following video presents the step-by-step nuances for an endoscope-assisted microsurgery for small vestibular schwannomas with stress on endoscopic drilling of the meatal wall to deliver out intracanacular tumor while preserving the labrynthine structures.






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