Document Detail

The transmastoid partial labyrinthectomy approach to medial skull base lesions.
MedLine Citation:
PMID:  10865478     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: It has long been thought that surgical disruption of the membranous labyrinth invariably results in sensorineural hearing loss and balance dysfunction. Recent evidence suggests that the inner ear can withstand such manipulation without loss of function. The technique of transmastoid partial labyrinthectomy has recently been described as a means of providing access to lesions of the medial skull base by removing part of the labyrinth and at the same time attempting to preserve hearing and vestibular function of the lateral semicircular canal (LSCC) and otolithic organs. PROCEDURE: An extended cortical mastoidectomy is performed and the posterior and middle cranial fossa dura are exposed widely. The posterior and superior semicircular canals are occluded at their ampullated ends and at the crus commune, and then resected. The LSCC and vestibule are left undisturbed. The petrous apex is removed and the medial end of the internal auditory canal is exposed. Posterior cranial fossa dural flaps are raised allowing access to the brainstem, petro-clival area and cerebellopontine angle. Temporal and suboccipital craniotomies can be performed, as required. RESULTS: Four patients underwent this procedure by a joint Otolaryngological-Neurosurgical team for access to the following lesions: three intra-axial pontine cavernomas and a basilar artery aneurysm. The preliminary hearing and balance results are discussed. CONCLUSIONS: The partial labyrinthectomy approach provides improved access to certain lesions of the medial skull base and requires less brain retraction compared with the retrolabyrinthine approach. It also has the potential to preserve serviceable hearing.
R M Walsh; M Tymianski; M C Wallace; A P Bath; M L Bance; J A Rutka
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Revue de laryngologie - otologie - rhinologie     Volume:  121     ISSN:  0035-1334     ISO Abbreviation:  Rev Laryngol Otol Rhinol (Bord)     Publication Date:  2000  
Date Detail:
Created Date:  2000-07-19     Completed Date:  2000-07-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0414144     Medline TA:  Rev Laryngol Otol Rhinol (Bord)     Country:  FRANCE    
Other Details:
Languages:  eng     Pagination:  13-20     Citation Subset:  IM    
University Health Network, Toronto General Hospital, Ontario, Canada.
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MeSH Terms
Basilar Artery / pathology,  radiography
Cerebellar Neoplasms / diagnosis,  surgery
Cerebellopontine Angle / pathology,  surgery
Cerebral Angiography
Ear, Inner / surgery*
Hemangioma, Cavernous / diagnosis,  surgery
Intracranial Aneurysm / diagnosis,  surgery
Magnetic Resonance Imaging
Mastoid / surgery*
Neurosurgical Procedures / methods*
Postoperative Complications
Skull Base Neoplasms / diagnosis,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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