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Nerve origin of vestibular schwannoma: a prospective study

Published online by Cambridge University Press:  27 November 2007

T Khrais*
Affiliation:
Department of Otolaryngology, Jordan University of Science and Technology, Jordan
G Romano
Affiliation:
Gruppo Otologico, Rome, Italy
M Sanna
Affiliation:
Gruppo Otologico, Rome, Italy
*
Address for correspondence: Dr Tarek Khrais, PO Box 3710, Irbid 21110, Jordan. Fax: 00962 2 7247850 E-mail: khraistarek@hotmail.com

Abstract

Objective:

The origin of vestibular schwannoma has always been a matter of debate. The aim of our study was to identify the nerve origin of this tumour.

Study design:

Prospective case review. This study was conducted at Gruppo Otologico, a private referral centre for neurotology and skull base surgery.

Methods:

A total of 200 cases of vestibular schwannoma were included in the study. All the tumours were removed surgically utilising the translabyrinthine approach. The origin of the tumour was sought at the fundus of the internal auditory canal.

Results:

A total of 200 consecutive cases was included in the study. The origin of the tumour was limited to one nerve at the fundus in 152 cases (76 per cent). Out of these cases, the tumour originated from the inferior vestibular nerve in 139 cases (91.4 per cent), from the superior vestibular nerve in nine cases (6 per cent), from the cochlear nerve in two cases (1.3 per cent) and from the facial nerve in two cases (1.3 per cent).

Conclusion:

The vast majority of vestibular schwannomas originate from the inferior vestibular nerve; the incidence of involvement of this nerve increases as the tumour size increases. An origin of vestibular schwannoma from the inferior vestibular nerve can be considered as one of the explanatory factors for the poor functional outcome of the extended middle cranial fossa approach, and probably accounts also for the better hearing preservation rate reported in some series for the retrosigmoid approach.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2007

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References

1 Ramsden, R. Acoustic tumors. In: Kerr, A, Booth, J, eds. Scott Brown's Otolaryngology, Otology. London: Butterworths, 1987;3:500–33Google Scholar
2 Becker, W, Naumann, HH, Pfaltz, CR. Ear in Becker W, Naumann HH, Pfaltz CR, Ear Nose and Throat Diseases. Thieme Stutgart, New York, 1994;130133Google Scholar
3 Roland, NJ, McRae, RD, McComber, AW. Acoustic Neuroma in Key Topics in Otolaryngology and Head and Neck Surgery. Oxford, England: BIOS Scientific Publishers Limited, 2001;14Google Scholar
4 Sanna, M, Saleh, E, Russo, A, Falcioni, M. Identification of the facial nerve in the translabyrinthine approach: an alternative technique. Otolaryngol Head Neck Surg 2001;124:105–6CrossRefGoogle ScholarPubMed
5 Sanna, M, Saleh, E, Panizza, B, Russo, A, Taibah, A. Atlas of Acoustic Neurinoma Microsurgery. Stuttgard: Thieme, 1998Google Scholar
6 Naguib, MB, Saleh, E, Cokkeser, Y, Aristegui, M, Landolfi, M, Taibah, AK et al. The enlarged translabyrinthine approach for removal of large vestibular schwannomas. J Laryngol Otol 1994;108:545–50CrossRefGoogle ScholarPubMed
7 Sanna, M, Agarwal, M, Jain, Y, Russo, A, Taibah, AK. Transapical extension in difficult cerebellopontine angle tumours: preliminary report. J Laryngol Otol 2003;117:788–92CrossRefGoogle ScholarPubMed
8 Cokkeser, Y, Aristegui, M, Naguib, MB, Saleh, E, Taibah, AK, Sanna, M. Identification of internal acoustic canal in the middle cranial fossa approach: a safe technique. Otolaryngol Head Neck Surg 2001;124:94–8CrossRefGoogle ScholarPubMed
9 Sanna, M, Russo, A, Taibah, A, Falcioni, M, Agarwal, M. Enlarged translabyrinthine approach for the management of large and giant acoustic neuromas: a report of 175 consecutive cases. Ann Otol Rhinol Laryngol 2004;113:319–28CrossRefGoogle ScholarPubMed
10 Ylikoski, J, Palva, T, Collan, Y. Eighth nerve in acoustic neuromas. Special reference to superior vestibular nerve function and histopathology. Arch Otolaryngolol 1978:104:532–7CrossRefGoogle Scholar
11 Clemis, JD, Ballad, WJ, Baggot, PJ, Lyon, ST. Relative frequency of inferior vestibular schwannoma. Arch Otolaryngol Head Neck Surg 1986;112:190–4CrossRefGoogle ScholarPubMed
12 Komatsuzaki, A, Tsunoda, A. Nerve origin of acoustic neuroma. J Laryngol Otol 2001;115:376–9CrossRefGoogle ScholarPubMed
13 Sanna, M, Khrais, T, Russo, A, Piccirillo, E, Augurio, A. Hearing preservation surgery in vestibular schwannoma: the hidden truth. Ann Otol Rhinol Laryngol 2004;113:156–63CrossRefGoogle ScholarPubMed
14 Irving, RM, Jackler, RK, Pitts, LH. Hearing preservation in patients undergoing vestibular schwannoma surgery: comparison of middle fossa and retrosigmoid approaches. J Neurosurg 1998;88:840–5CrossRefGoogle ScholarPubMed