FEASIBILITY AND EFFECTIVENESS OF RETROSIGMOID APPROACH IN VESTIBULAR SCHWANNOMA SURGERY

Purpose: To assess the feasibility and effectiveness of the lateral suboccipital retrosigmoid approach in the surgical management of vestibular schwannoma.

Materials and Methods: We conducted a prospective hospital-based case series conducted on 356 patients during the period from May 2018 to May 2020 in collaboration with the neurosurgery department, "Sohag University hospital", and "Tokyo Medical University Hospital". Patients included who were undergoing surgical intervention for vestibular schwannoma (VS) through retrosigmoid approach. All patients in our study were followed up for a minimum of four months. For each patient intraoperative tumor resection volume was recorded, postoperative complications, facial and cochlear nerve functions were assessed.

Results: Enrolled in this study 356 cases, the majority (54.8%) of patients were females; while (45.2%) were males were included with a mean age (42.57 ± 12.3) years. We achieved a mean follow-up of 6.2 months; ranging (4-9 months). Postoperative scoring of facial nerve function was a good outcome in 79.4%, fair outcome in 17.5%, and poor outcome in 3.1%.

Conclusion: We assessed the results of surgery using a retrosigmoid approach in 356 patients with VS. Surgical management of VS using retrosigmoid approach is safe and effective but after the advancement of microsurgical techniques like drilling and neurophysiological monitoring especially for seventh and eighth cranial nerves, the possibility of preserving the facial and cochlear functions became more feasible with excellent results.