Work

Neuroendoscopy Combined with Intraoperative Electrophysiological Monitoring for the Protection of the Facial Nerve in Near Total Resection Surgery for Acoustic Neuroma

Year: 2025

Type: article

Abstract: OBJECTIVE: Acoustic neuromas, or vestibular schwannomas, pose significant surgical challenges due to their proximity to critical cranial nerves, particularly the facial nerve. The primary goal in their surgical treatment is to achieve maximal tumor removal while preserving neurological function. Recent advancements in surgical technology have introduced neuroendoscopy as an adjunctive tool that can enhance visualization during surgery. This study aimed to evaluate the efficacy of integrating neuroendoscopy with intraoperative electrophysiological monitoring in near-total resection surgeries for acoustic neuroma. METHODS: We conducted a retrospective cohort study comparing 71 patients who underwent neuroendoscopy-assisted microsurgery technique with 68 patients who received standard care group technique. Both groups underwent the suboccipital retrosigmoid sinus approach for tumor resection with intraoperative electrophysiological monitoring. Surgical outcomes, including residual tumor size, facial nerve function, audiological outcomes, and complication rates, were compared between the two groups. RESULTS: The neuroendoscopy-assisted group demonstrated a significantly smaller residual tumor size, improved immediate and 1-year postoperative House-Brackmann grades, and a higher facial nerve preservation rate compared to the standard care group (p<0.05). There was no significant difference in operation time, blood loss, cerebrospinal fluid leakage, or complication rates between the groups. Word recognition scores after a year were significantly higher in the neuroendoscopy-assisted group (p<0.05). CONCLUSION: The integration of neuroendoscopy-assisted microsurgery technique in acoustic neuroma surgery improves facial nerve function and residual tumor size without increasing surgical complications. These findings support the utility of this combined approach in enhancing surgical outcomes for patients with acoustic neuroma.

Source: Journal of Korean Neurosurgical Society

DOI: 10.3340/jkns.2025.0026

Authors: Yong Zhang, Guixin Shi, Shunwu Xiao

Institutions: Zunyi Medical University, Affiliated Hospital of Zunyi Medical College

Language: English

Topic: Meningioma and schwannoma management

Subfield: Epidemiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $300