Endoscopic-assisted microsurgical resection of giant vestibular schwannoma in semi-sitting position

Neurosurg Focus Video. 2021 Oct 1;5(2):V3. doi: 10.3171/2021.7.FOCVID2176. eCollection 2021 Oct.

Abstract

The main objectives of microsurgery for vestibular schwannoma are total tumor removal and preservation of facial and cochlear nerve function. For giant tumors, total tumor removal and facial nerve function preservation are challenging. The semisitting position has some advantages. In this video the authors show the removal of a giant vestibular schwannoma with the patient in a semisitting position. They demonstrate the advantages of the semisitting technique, such as the two-handed microsurgical dissection technique and a clear operative field. Finally, a small residual tumor in the internal auditory canal was removed by endoscopy. The patient's facial function was House-Brackmann grade I at discharge. The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID2176.

Keywords: facial nerve; semisitting position; vestibular schwannoma.