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academies
September 10-11, 2018 | Paris, France
&
Joint Event
Otolaryngology: ENT Surgery
6th International Conference on
Cell & Stem Cell Research
World Congress and Expo on
Journal of Otolaryngology Online Journal | Volume 8
Endoscope assisted retro sigmoid approach and internal auditory nerve canal compression syndromes
Arianna Di Stadio
Sapienza University of Rome, Italy
Introduction: The use of surgical decompression for treating
nerve compression due to the loop in the internal auditory
canal is not always accepted due to the risk related to the
surgical procedure. Currently a new surgical technique allows
surgeons to work in safer conditions.
Objective: To report the results with endoscope-assisted
retro sigmoid approach for facial nerve or cochlear nerve
microvascular decompression in hemifacial spasm due to
neurovascular conflict.
Methods: We carried out a prospective study in a tertiary
referral centre observing 12 (5male, 7 female) patients affected
by hemifacial spasm, and three patients (2 men, 1 woman)
affected from tinnitus due to a compression of cochlear nerve
that underwent to an endoscope assisted retro sigmoid approach
for microvascular decompression. We evaluated intra-operative
findings, postoperative resolution and complication rates.
Results: Hemifacial spasm resolution was noticed in 9/12
(75%) cases within 24 hours after surgery and in 12/12 (100%)
subjects within 45 days. A significant (p < 0.001) correlation
between preoperative historical duration of hemifacial
spasm and postoperative recovery timing was recorded. Only
1 patient had a complication (meningitis), which resolved
after intravenous antibiotics with no sequelae. No cases of
cerebrospinal fluid leak, facial palsy or hearing impairment
were recorded. Hemifacial spasm recurrence was noticed
in the only subject where the neurovascular conflict was
due to a vein within the internal auditory canal. None of
the patients with tinnitus reported short-term or long-term
complications after surgery. After surgery, tinnitus resolved
immediately in 2 patients, whereas in the other patient
symptoms persisted although they improved; in all patients,
hearing was preserved and ABR improved.
Conclusions: The endoscope assisted retro sigmoid approach
technique offers anoptimal visualization of the neurovascular
conflict thorough a minimally invasive approach, thus
allowing an accurate decompression of the facial nerve with
low complication rates. Due to the less invasive nature, the
procedure should be considered in functional surgery of the
cerebellar pontine angle as hemifacial spasm treatment or
cochlear nerve compression.
Speaker Biography
Arianna Di Stadio is an Otolaryngologist, specialized in otology/neurotology, facial
plastic surgery, and microsurgery. She is currently responsible for the otolaryngology
research line at the San Camillo Hospital IRCCS in Venice, Italy. She collaborates with
the Columbia University of New York and the Wayne University in Detroit. She is the
reviewer for several International peer-reviewed journals and she is the author of
several articles published in international journals.
e:
Arianna Di Stadio, ENT and Stem Cell 2018, Volume 8
DOI: 10.4066/2250-0359-C1-002