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Vol. 32. Issue 6.
Pages 268-277 (November - December 2021)
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Vol. 32. Issue 6.
Pages 268-277 (November - December 2021)
Clinical research
Endoscopic retrosigmoid keyhole approach in cerebellopontine angle tumors. A surgical cohort
Keyhole endoscópico retrosigmoideo en tumores del ángulo pontocerebeloso. Resultados de una serie
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Joel Caballero-García
Corresponding author
joelcaballero.ns@gmail.com

Corresponding author.
, Iosmill Morales-Pérez, Adolfo Michel-Giol-Álvarez, Carlos Aparicio-García, Misael López-Sánchez, Juvenal Huanca-Amaru
Servicio de Neurocirugía, Instituto Nacional de Oncología y Radiobiología, La Habana, Cuba
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Table 1. Summary of the clinical data of the series (n=40).
Abstract
Introduction and objectives

To determine the safety and efficacy of endoscopic keyhole surgery in patients with cerebellopontine angle tumours.

Materials and methods

This was a retrospective study of patients with cerebellopontine angled tumours treated by fully endoscopic retrosigmoid keyhole approach in a tertiary centre during a period of four years. Preoperative, transoperative and postoperative variables were analysed.

Results

A number of 40 patients were included. The age average was 49.4 years and male/female proportion was 0.4–1. We found 31 vestibular schwannomas (77.5%), five meningiomas (12.5%), two cholesteatomas (5.0%) and two metastases (5.0%). Vestibular schwannomas Hannover type IIIb, IVa and IVb predominated. The surgical resection was total or near-total 92.5% of patients. Hearing preservation rate was 62.5% and acceptable facial function nerve function rate was 80% after six months. Hospital stay was 7.5 days. The total or near total resection and functionally preservation rate was high. Complications were unusual.

Conclusions

Endoscopic retrosigmoid keyhole approach represented a safe and efficient procedure in selected patients with cerebellopontine angle tumours.

Keywords:
Cerebellopontine angled tumours
Vestibular schwannoma
Endoscopy
Retrosigmoid keyhole
Resumen
Introducción y objetivos

Evaluar la seguridad y eficacia del abordaje tipo keyhole endoscópico retrosigmoideo en pacientes con tumores del ángulo pontocerebeloso.

Material y método

Se expone una serie clínica retrospectiva y unicéntrica de pacientes con tumores del ángulo pontocerebeloso tratados en un periodo de cuatro años, empleando craneotomía retrosigmoidea tipo keyhole con visualización completamente endoscópica. Se analizaron variables preoperatorias, transoperatorias y postoperatorias.

Resultados

Se estudiaron 40 pacientes con edad promedio de 49,4 años y proporción masculino/femenino de 0,4:1. De ellos, 31 presentaron schwanomas vestibulares (77,5%), cinco meningiomas (12,5%), dos colesteatomas (5,0%) y dos metástasis (5,0%). Predominaron los schwanomas vestibulares tipo Hannover IIIb, IVa y IVb. La resección fue total o casi total en el 92,5% de los pacientes. Se conservó la audición en el 62,5% de los pacientes y el 80% presentó función aceptable del nervio facial a los seis meses. La estadía hospitalaria promedio fue de 7,5 días. Se observó un elevado porcentaje de resección total o casi total y de recuperación funcional. La frecuencia de complicaciones fue baja.

Conclusiones

El abordaje tipo keyhole endoscópico retrosigmoideo constituyó un procedimiento seguro y eficaz en los pacientes con tumores del ángulo pontocerebeloso seleccionados.

Palabras clave:
Tumores del ángulo pontocerebeloso
Schwanoma vestibular
Endoscopía
Keyhole retrosigmoideo

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