caa a22 4500 445297921 CHVBK 20180317142547.0 cr unu---uuuuu 170323e20101001xx s 000 0 eng 10.1007/s12070-010-0057-x doi (NATIONALLICENCE)springer-10.1007/s12070-010-0057-x The Enlarged Translabyrinthine and Transapical Extension Type I Approach for Large Vestibular Schwannomas [Elektronische Daten] [N. Jayashankar, K. Morwani, S. Sankhla, R. Agrawal] To evaluate the results obtained by performing the enlarged translabyrinthine and transapical extension type I approaches for removal of large vestibular schwannomas and those with anterior extensions. An academic tertiary referral centre at Mumbai, India. Retrospective case review. 35 patients of vestibular schwannomas having size greater than 3cm in extrameatal diameter with extension anterior to the internal auditory canal who underwent the enlarged translabyrinthine or transapical extension type I approach and with a minimum follow up of 1year are considered. Other subjects who underwent translabyrinthine approach but did not fulfill the above criteria were excluded. Tumor was removed completely in 34 subjects (97.1%). Anatomic interruption of facial nerve occured in 4 cases (11.4%); 3 subjects underwent end to end anastomosis and 1 subject required a cable graft, these were done during the primary procedure itself. At 1 year follow up 28 subjects (80%) had good facial function (Grade I and II, House Brackmann Grading). Postoperative cerebrospinal fluid leak was encountered in 1 subject (2.9%). 34 subjects (97.1%) had a normal albeit slow gait by the sixth post-operative day. Complete tumor removal with a very low morbidity in our series suggest that the enlarged translabyrinthine and transapical extension type I approach offers excellent control of the neurovascular structures in the cerebellopontine angle as also of the large vestibular schwannoma itself aiding complete removal. It also offers the advantage of management of the interrupted facial nerve at the primary procedure itself since the proximal and distal segments are in the operative field. Association of Otolaryngologists of India, 2010 Acoustic neuroma nationallicence Facial nerve nationallicence Vestibular schwannoma nationallicence Translabyrinthine approach nationallicence Jayashankar N. The Skull Base Group, Dr Balabhai Nanavati Hospital and Medical Research Centre, S V Road, Vile Parle West, 400 056, Mumbai, India aut Morwani K. The Skull Base Group, Dr Balabhai Nanavati Hospital and Medical Research Centre, S V Road, Vile Parle West, 400 056, Mumbai, India aut Sankhla S. The Skull Base Group, Dr Balabhai Nanavati Hospital and Medical Research Centre, S V Road, Vile Parle West, 400 056, Mumbai, India aut Agrawal R. The Skull Base Group, Dr Balabhai Nanavati Hospital and Medical Research Centre, S V Road, Vile Parle West, 400 056, Mumbai, India aut Indian Journal of Otolaryngology and Head & Neck Surgery Springer-Verlag 62/4(2010-10-01), 360-364 0019-5421 62:4<360 2010 62 12070 https://doi.org/10.1007/s12070-010-0057-x text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12070-010-0057-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Jayashankar N. The Skull Base Group, Dr Balabhai Nanavati Hospital and Medical Research Centre, S V Road, Vile Parle West, 400 056, Mumbai, India aut NATIONALLICENCE 700 1- Morwani K. The Skull Base Group, Dr Balabhai Nanavati Hospital and Medical Research Centre, S V Road, Vile Parle West, 400 056, Mumbai, India aut NATIONALLICENCE 700 1- Sankhla S. The Skull Base Group, Dr Balabhai Nanavati Hospital and Medical Research Centre, S V Road, Vile Parle West, 400 056, Mumbai, India aut NATIONALLICENCE 700 1- Agrawal R. The Skull Base Group, Dr Balabhai Nanavati Hospital and Medical Research Centre, S V Road, Vile Parle West, 400 056, Mumbai, India aut NATIONALLICENCE 773 0- Indian Journal of Otolaryngology and Head & Neck Surgery Springer-Verlag 62/4(2010-10-01), 360-364 0019-5421 62:4<360 2010 62 12070 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer