Generating Operative Workflows for Vestibular Schwannoma Resection: A Two-Stage Delphi's Consensus in Collaboration with the British Skull Base Society. Part 2: The Translabyrinthine Approach

Abstract Objective An operative workflow systematically compartmentalizes operations into hierarchal components of phases, steps, instrument, technique errors, and event errors. Operative provides a foundation for education, training, understanding surgical variation. In this Part 2, we present codified the translabyrinthine approach to vestibular schwannoma resection. Methods A mixed-method consensus process literature review, small-group Delphi's consensus, followed by national was performed in collaboration with British Skull Base Society (BSBS). Each round repeated until data saturation over 90% reached. Results Seventeen consultant skull base surgeons (nine neurosurgeons eight ENT [ear, nose, throat]) median 13.9 years experience (interquartile range: 18.1 years) independent practice participated. There 100% response rate across both Delphi rounds. The had following five phases 57 unique steps: Phase 1, exposure; mastoidectomy; 3, internal auditory canal dural opening; 4, tumor debulking excision; 5, closure. Conclusion We 2 national, multicenter, consensus-derived, schwannomas. contain operative, instruments, presented manuscript can serve as foundational research future work, such application artificial intelligence resection comparative research.