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European Archives of Oto-Rhino-Laryngology

Erschienen in:

04.09.2023 | Otology

Superior petrosal vein sacrifice in translabyrinthine approach for resection of vestibule schwannoma

verfasst von: Yongjie Wang, Gianluca Piras, Lorenzo Lauda, Antonio Caruso, Alessandra Russo, Abdelkader Taibah, Mario Sanna

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 3/2024

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Abstract

Purpose

The aim of this study was to evaluate the safety and surgical outcome of superior petrosal vein (SPV, Dandy’s vein) sacrifice in translabyrinthine approach (TLA) for resection of vestibule schwannoma (VS) as compared with SPV preservation, with further investigation of preoperational factors associated with the implement of SPV sacrifice.

Methods

The authors prospectively collected data from patients surgically treated for VS through TLA between June 2021 and April 2022 at the Gruppo Otologico.

Results

There were 30 and 49 patients in SPV sacrifice and preservation groups, respectively. SPV sacrifice group had significantly larger tumor size (2.46 vs. 1.40 cm), less percentage of solid tumor (26.7% vs. 83.7%), higher incidence of brainstem compression (80% vs. 26.5%), and higher percentage of facial numbness (20.0% vs. 4.1%) than SPV preservation group. Gross total resection (GTR) rates were 73.3% after SPV sacrifice and 87.8% after SPV preservation. Facial nerve preservation rates were similar. No complication related with SPV sacrifice was observed. Logistic regression analysis showed tumor size and complete solid consistency as significant risk factors associated with SPV sacrifice. ROC curve further demonstrated tumor size as a fair predictor (AUC = 0.833), with optimum cutoff value of 1.68 cm.

Conclusion

SPV sacrifice via TLA as needed is a safe and effective maneuver for removal of relatively large VS. Tumor size and consistency can be used as a guidance in preoperational decision-making, with cutoff value of 1.68 cm and cystic formation as predictive indicators.

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Titel: Superior petrosal vein sacrifice in translabyrinthine approach for resection of vestibule schwannoma
verfasst von: Yongjie Wang
Gianluca Piras
Lorenzo Lauda
Antonio Caruso
Alessandra Russo
Abdelkader Taibah
Mario Sanna
Publikationsdatum: 04.09.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: European Archives of Oto-Rhino-Laryngology / Ausgabe 3/2024
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI: https://doi.org/10.1007/s00405-023-08208-1

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