vestibular schwannomas microsurgery assisted by flexible hand-held 2μ-thulium-fiber laser

Authors

luciano mastronardi san filippo neri hospital, department of neurological sciences, division of neurosurgery, roma, italy; [email protected]

guglielmo cacciotti

raffaele roperto

maria pia-tonelli

abstract

background: vestibular schwannoma (vs) is one of the skull base tumors originating from vestibular portion of eighth cranial nerve. recently, 2μ- thulium laser is used in the surgery of some intracranial tumors. objectives: assessing the efficacy of 2μ-thulium flexible hand-held laser fiber (revolixjrò) in microsurgical removal of vs. materials and methods: this retrospective non-randomized study was carried out from july 2012 to november2015.39 patients with vs had been operated on with microsurgical technique via retro-sigmoid approach. 2μ-thulium-fiber hand-held flexible laser was used for tumor resection in 39 cases. facial nerve function by house-brackmann (hb) scale and hearing state were assessed preoperatively and 1 week and 6-month postoperatively. results: overall time of surgery changed only in proportion with the size of tumor (185-575 minutes) and was not affected by the use of laser. in 5out of 39cases, preoperative facial nerve palsy hb2, and in one case hb4 (permanent) was observed. on considering 38 cases, at 6-month follow-up facial nerve preservation rate (hb1) was 92.1% (from may 2015 all patients had not postoperative facial palsy). hearing preservation rate was possible in 12 out of 15 cases with previously acceptable preoperative hearing state (aao-hns a and b classes). the mean surgeon satisfaction rate of usefulness of this technic was 2.7 in a 0-3-scale conclusions: a good functional outcome including facial nerve preservation and hearing preservation was obtained by μ-thulium-fiber hand-held flexible laser microsurgery.

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Journal title:
caspian journal of neurological sciences

جلد ۲، شماره ۷، صفحات ۱-۹

Keywords
[ ' v e s t i b u l a r s c h w a n n o m a ' , ' f a c i a l n e r v e p r e s e r v a t i o n ' , ' h e a r i n g p r e s e r v a t i o n ' , 2 , ' μ t h u l i u m l a s e r ' ]

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