Objective: To illustrate successful surgical management of vestibular schwannomas via an exclusively endoscopic transcanal transpromontorial approach (EETTA).
Patients: 62-year-old male with an intracanalicular (Koos stage I) vestibular schwannoma and a 46-year-old female with a Koos stage II vestibular schwannoma.
Intervention(s): Surgical excision via an EETTA.
Main Outcome Measure(s): Completeness of resection and approach morbidities.
Results: Both patients had successful complete tumor removal via this minimally invasive approach. The patients had no intraoperative complications, which includes minimal bleeding and preservation of normal facial function. Both had uneventful hospital stays with minimal pain and no cerebrospinal fluid leak. One patient had a delayed facial paralysis that resolved back to House-Brackmann grade I following a course of oral steroids.
Conclusions: To our knowledge, this is the first report of the EETTA in North America. It adds to a growing body of evidence in support of endoscopics for the management of lateral skull base pathology. Additional studies are needed to fully elucidate the risk-benefit profile of this approach.