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Chapter 12 - Transcochlear and Extended/Combined Transcochlear Approaches for Complex Tumors of the Skull Base and Posterior Cranial Fossa

from Section II - Open Combined Approaches

Published online by Cambridge University Press:  05 October 2021

By
Emily Guazzo ,
Arturo Solares  and
Ben Panizza
Edited by
Vijay Agarwal
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Summary

There is no single optimal approach for all skull base pathologies and locations. Skull base surgeons must tailor their surgery to both the tumor and the goals of care for the patient to optimize conditions for tumor removal while minimizing morbidity. Lateral skull base approaches are an attractive option to access the skull base given the direct surgical access to the lower cranial nerves, the intra- and extratemporal internal carotid artery (ICA), and the venous sinuses. These approaches can be broadly classified as otic capsule-sparing and otic capsule-sacrificing. These approaches are complex in nature, and patient selection on a case-by-case basis with multidisciplinary input is essential. Complex skull base tumors may not be adequately addressed with a single surgical approach and may require a combination or modification of these techniques. In this chapter, we will describe transcochlear approaches and how they can be modified to provide extended skull base access.

Keywords

lateral skull basetransoticotic capsule-sparingotic capsule-sacrificing
Type
Chapter
Information
Integrated Management of Complex Intracranial Lesions
Open, Endoscopic, and Keyhole Techniques
 , pp. 122 - 139
Publisher: Cambridge University Press
Print publication year: 2021

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References

Oghalai, J.S., and Driscoll, C.L.W., Atlas of Neurotologic and Lateral Skull Base Surgery. 1st ed. 2016: Berlin, Heidelberg: Springer.CrossRefGoogle Scholar
Sanna, M., et al., Atlas of Microsurgery of the Lateral Skull Base. 2nd ed. 2007: New York: Thieme.Google Scholar
Roberson, J.B., Jr., Brackmann, D.E., and Fayad, J.N., Complications of venous insufficiency after neurotologic-skull base surgery. Am J Otol, 2000. 21(5): pp. 701–5.Google ScholarPubMed
House, W.F., and Hitselberger, W.E., The transcochlear approach to the skull base. Arch Otolaryngol, 1976. 102(6): pp. 334–42.Google Scholar
Goddard, J.C., and McRackan, T.R., Transcochlear approach to cerebellopontine angle lesions, in Otologic Surgery, Brackmann, D.E., Shelton, C., and Arriaga, M.A., eds. 2016: Amsterdam: Elsevier; pp. 557–66.Google Scholar
Chawla, S, and Bowman, J.B., The transotic and transcochlear approaches. Operative Techniques in Otolaryngology – Head and Neck Surgery, 2013. 24(3): pp. 157–62.CrossRefGoogle Scholar
Angeli, S.I., De la Cruz, A., and Hitselberger, W., The transcochlear approach revisited. Otology & Neurotology, 2001. 22(5): pp. 690–5.Google Scholar
Sanna, M., et al., Surgical management of jugular foramen schwannomas with hearing and facial nerve function preservation: a series of 23 cases and review of the literature. Laryngoscope, 2006. 116(12): pp. 2191–204.CrossRefGoogle ScholarPubMed
Fisch, U., Infratemporal fossa approach to tumors of the temporal bone and base of the skull. Journal of Laryngology & Otology, 1978. 92(11): pp. 949–67.CrossRefGoogle ScholarPubMed
Chan, J., et al., Anterior and subtemporal approaches to the infratemporal fossa, in Otologic Surgery, Brackmann, D.E., Shelton, C., and Arriaga, M.A., eds. 2016: Amsterdam: Elsevier; pp. 557–66.Google Scholar
Anderson, S.B., and Panizza, B.M., Petro-occipital transsigmoid approach. Operative Techniques in Otolaryngology – Head and Neck Surgery, 2013. 24(3): pp. 163–8.Google Scholar
Mazzoni, A., et al., Lower cranial nerve schwannomas involving the jugular foramen. Annals of Otology, Rhinology & Laryngology, 1997. 106(5): pp. 370–9.Google Scholar
Mazzoni, A., and Sanna, M., A posterolateral approach to the skull base: the petro-occipital transsigmoid approach. Skull Base Surg, 1995. 5(3): pp. 157–67.CrossRefGoogle Scholar
Mann, W.J., et al., Transsigmoid approach for tumors of the jugular foramen. Skull Base Surg, 1991. 1(3): pp. 137–41.CrossRefGoogle ScholarPubMed
Tucci, D.L., Kaylie, D.M., and Fukushima, T., Extreme lateral infrajugular transcondylar approach for resection of skull base tumors, in Otologic Surgery, Brackmann, D.E., Shelton, C., and Arriaga, M.A., eds. 2016: Amsterdam: Elsevier; pp. 634–45.Google Scholar
Lazard, D.S., et al., Early complications and symptoms of cerebellopontine angle tumor surgery: a prospective analysis. Eur Arch Otorhinolaryngol, 2011. 268(11): pp. 1575–82.CrossRefGoogle ScholarPubMed
Darrouzet, V., et al., Vestibular schwannoma surgery outcomes: our multidisciplinary experience in 400 cases over 17 years. Laryngoscope, 2004. 114(4): pp. 681–8.Google Scholar
Samii, M., and Matthies, C., Management of 1000 vestibular schwannomas (acoustic neuromas): the facial nerve–preservation and restitution of function. Neurosurgery, 1997. 40(4): pp. 684–94; discussion 694–5.Google Scholar
Schick, B., and Dlugaiczyk, J., Surgery of the ear and the lateral skull base: pitfalls and complications. GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery, 2013. 12: p. Doc05.Google Scholar
Russel, A., et al., Can the risks of cerebrospinal fluid leak after vestibular schwannoma surgery be predicted? Otol Neurotol, 2017. 38(2): pp. 248–52.Google Scholar
Fishman, A.J., et al., Prevention and management of cerebrospinal fluid leak following vestibular schwannoma surgery. The Laryngoscope, 2009. 114(3): pp. 501–5.Google Scholar
Heman-Ackah, S.E., J.G. Golfinos, and J.T. Roland, Management of surgical complications and failures in acoustic neuroma surgery. Otolaryngologic Clinics of North America, 2012. 45(2): pp. 455–70.Google Scholar
Teachey, W., et al., Intervention for elevated intracranial pressure improves success rate after repair of spontaneous cerebrospinal fluid leaks. The Laryngoscope, 2017. 127(9): pp. 2011–16.Google Scholar
Chaaban, M.R., et al., Acetazolamide for high intracranial pressure cerebrospinal fluid leaks. International Forum of Allergy & Rhinology, 2013. 3(9): pp. 718–21.Google Scholar
Rubin, R.C., et al., The production of cerebrospinal fluid in man and its modification by acetazolamide. J Neurosurg, 1966. 25(4): pp. 430–6.CrossRefGoogle ScholarPubMed
Wilkinson, E.P., Brackmann, D.E., and Lupo, J.E., Management of postoperative cerebrospinal fluid leak, in Otologic Surgery, Brackmann, D.E., Shelton, C., and Arriaga, M.A., eds. 2016: Amsterdam: Elsevier; pp. 646–52.Google Scholar
Allen, K.P., et al., Lumbar subarachnoid drainage in cerebrospinal fluid leaks after lateral skull base surgery. Otol Neurotol, 2011. 32(9): pp. 1522–4.CrossRefGoogle ScholarPubMed
Crowson, M.G., et al., Preoperative lumbar drain use during acoustic neuroma surgery and effect on CSF leak incidence. Ann Otol Rhinol Laryngol, 2016. 125(1): pp. 63–8.Google Scholar
Poe, D.S., et al., Long-term results after lateral cranial base surgery. Laryngoscope, 1991. 101(4 Pt 1): pp. 372–8.Google ScholarPubMed
Brackman, D., Kinney, S., and Fu, K., Glomus tumor: diagnosis and management. Head Neck Surg, 1987. 9(5): pp. 306–11.Google Scholar
Sanna, M., et al., Petrous bone cholesteatoma: classification, management and review of the literature. Audiol Neurootol, 2011. 16(2): pp. 124–36.Google Scholar
Russo, A., et al., Anterior and posterior facial nerve rerouting: a comparative study. Skull Base, 2003. 13(3): pp. 123–30.Google Scholar

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