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Minimally Invasive Endoscopic and Endoscopy-Assisted Microsurgery of Vestibular Schwannoma

Publication at Central Library of Charles University |
2011

Abstract

The recent technological advances provided high-quality endoscopes of small diameters and varying lengths and angles, irrigation sheaths for cleaning the lenses inside the optative field, endoscope holders that allow the surgeon to continue using their bimanual microsurgical skills and sophisticated instruments suitable for endoscopic microsurgery. These improvements permit us to use the endoscope, with its wide panoramic, multiangled, and close-up view of the anatomic structures, to ideally express its best properties in deepseated and narrow space-located lesions of the skull base.

The introduction of endoscopic technique into the repertoire of the surgical methods of treatment of the cerebellopontine angle (CPA) pathologies has proved to be useful. Although only limited surgical series concerning the employment of the endoscopic techniques for the removal of vestibular schwannomas have been reported recently, it seems clear that the endoscopes offer some advantages over the conventional microsurgical technique ether in reducing the invasiveness or in allowing safer and more radical tumor removal, thus helping to lower the complication rate and improving the results.

Review of endoscopic and endoscopy-assisted microsurgery of the CPA pathologies, endoscopic anatomy of the CPA and surgical technique are presented.