Early post-operative outcomes in patients operated for vestibular schwannoma: comparison between transcanal endoscopic and retrosigmoid approaches.

Vestibular schwannomas account for about 85% of cerebellopontine angle tumors in adults and most commonly arise from the inferior division of the vestibular nerve. Surgical and imaging techniques have evolved to offer earlier detection and the potential for hearing preservation. Three main surgical techniques are developed for the removal of vestibular schwannomas: middle cranial fossa, retrosigmoid, and translabyrinthine approaches. In addition, we have the fully endoscopic technique, which is becoming a preferred approach used by prepared otosurgeons. Each surgical approach has unique advantages and limitations. For example, the middle cranial fossa and retrosigmoid approaches make hearing preservation possible in selected patients, whereas the translabyrinthine approach precludes hearing preservation because it involves a labyrinthectomy. A good understanding of the main surgical approaches, relevant anatomic considerations, surgical complications, and likelihood of tumor recurrence is essential for interpreting magnetic resonance images (imaging plays a key role in preoperative assessment and postoperative management in affected patients) to the advantage of both the surgeon and the patient, particularly when hearing preservation is a consideration. Our study is centered on the retrosigmoid and transcanal endoscopic approaches. We evaluated and compared the early post-surgery outcomes (gravity) encountered with either methods. Outcomes evaluated include vertigo, nausea, pain, drowsiness, facial injury and early complications.