Application of Ultrasonic Bone Aspirator for Decompression of the Internal Auditory Canal via the Middle Cranial Fossa Approach
| Autor: | Ravi N. Samy, Mario Zuccarello, Norberto Andaluz, Vincent A. DiNapoli, Joseph T. Breen, Zoe A Walters, Myles L. Pensak, Gavriel D. Kohlberg, Kareem O. Tawfik, Noga Lipschitz |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Leak medicine.medical_specialty Adolescent Decompression Schwannoma Middle cranial fossa Neurosurgical Procedures Young Adult Cerebrospinal fluid medicine Humans Ultrasonics Aged Retrospective Studies Cranial Fossa Middle business.industry Retrospective cohort study Neuroma Acoustic Middle Aged Decompression Surgical Neuroma medicine.disease Facial nerve Sensory Systems Surgery Facial Nerve medicine.anatomical_structure Otorhinolaryngology Ear Inner Female Neurology (clinical) business |
| Zdroj: | Otology & Neurotology. 40:114-120 |
| ISSN: | 1537-4505 1531-7129 |
| Popis: | Objective Evaluate the safety and efficacy of the ultrasonic bone aspirator (UBA) during middle cranial fossa (MCF) approach to vestibular schwannoma (VS). Study design Retrospective case series. Setting Tertiary referral center. Patients Charts of 192 consecutive VS patients over 18 years of age were reviewed to identify 65 patients who underwent MCF approach to VS resection between 2006 and 2017. A combination of UBA and high-speed drill (HSD) was used to decompress the internal auditory canal (IAC) in 25 patients and HSD alone was used in the other 40 patients. Intervention(s) Use of UBA during vestibular schwannoma surgery via MCF approach for decompression of the IAC. Main outcome measure(s) Postoperative facial nerve outcomes assessed by the House-Brackmann (HB) facial nerve grading scale. Rates of gross total resection (GTR) and cerebrospinal fluid (CSF) leak. Results There were no significant differences in postoperative facial nerve function, in rate of GTR of tumor, or in rate of CSF leak. In the UBA group 24/25 (96%) had postoperative HB grade I-II compared with 36/40 (90%) in the HSD group (p-value = 0.66). GTR was achieved in 25/25 (100%) in the UBA group compared with 38/40 (95%) in the HSD group (p-value = 1). In the UBA group, there were 0/25 (0%) cases of CSF leak compared with 1/40 (2.5%) in the HSD group (p-value = 1). Conclusions UBA use is a safe and effective alternative or adjunct to HSD during MCF approach to expose the IAC contents. This surgical tool allows for bone removal with low risk of injury to adjacent structures. |
| Databáze: | OpenAIRE |
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