ArticleEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026
Hearing preservation in vestibular schwannoma with retrosigmoid approach: updating retrolabyrinthine meatotomy.
Article in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeReport the updated version of retrolabyrinthine meatotomy (RLM) to the whole internal auditory canal in hearing preservation surgery (HPS) via retrosigmoid approach (RS) in sporadic vestibular schwannoma (VS).
methodsDescription of surgical technique of VS removal with microscopic RS approach and RLM. Fifty-six consecutive patients with intrameatal or small (up to 15 mm extrameatal size) sporadic VS, with fundus free or fundus involved by the tumor, and good hearing at diagnosis, who underwent HPS, were retrospectively reviewed. Elective (protocol) indication for HPS was ≤ 10 mm size, ≤ 30 PTA, and ≥ 70 SDS.
resultsComplete VS removal was achieved in all 56 cases, with no residual tumor or recurrence. The overall hearing preservation rate was 64% (36/56 patients), and 66% (28/42 patients) in protocol cases. Hearing outcome in fundus free vs. fundus involved cases did not show significant difference. At one-year postoperative follow-up, facial nerve function was House-Brackmann (HB) grade 1 or 2 in 54/56 patients (96%) and grade 3 in 2/56 patients (4%). The rate of relevant complications was 11% (6/56), with nasal CSF leak being the most frequent; no permanent sequelae occurred.
conclusionsMicroscopic RLM with three-dimensional view is a convenient option to expose the internal auditory canal up to the fundus and to remove VS irrespective of fundus involvement.
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