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April2012 Vol.49 Issue:        2        Table of Contents
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Assessment of Endoscopic Assisted Microsurgery in Treatment of Cerebellopontine Angle Lesions

Ali S. Abdelmolaa, Nabil H. Khalil, Nader E. Negm, Esam A. Elkhatib,

Khaled E. Mohamed


Department of Neurosurgery, Suez Canal University; Egypt

 



ABSTRACT

Background: The use of the endoscope can compensate for the deficiencies of the microscope which are the reduction of light intensity in the depth of the operating field and lack of wider viewing angles. Objective: to assess the effectiveness of endoscopic assisted microsurgery in the treatment of cerebellopontine pathologies. Methods: A prospective descriptive clinical study of surgical management of 25 patients with cerebellopontine angle pathologies was done in Suez Canal University Hospital; from January 2008 until August 2010. A rigid endoscope was used with both angles the zero0 and 30°. Results: Complete tumor removal achieved in 85.7% with recurrence in (6.25%). In 24%, opened air cells and in 16% residual tumors were seen only with the endoscope. The facial and auditory nerves were left intact after the procedure in 92% and 80% respectively. In 40%, the vessel causing trigeminal neuralgia and final microvascular decompression and Teflon insertion were properly achieved with the endoscope. The operative time added by endoscope ranged from 15 to 45 minutes. Complications occurred in 36% of patients, but most of them were simple and recoverable with no intraoperative mortality. Postoperatively 24% had increased facial weakness most of them improved during follow up, 20% showed increased hearing deficits. The facial nerve preservation and hearing preservation were increased by the use of the endoscope. Conclusion: Endoscopic assisted microsurgery for treatment of cerebellopontine angle (CPA) pathologies is effective and safe procedure ensuring surgical success with less postoperative morbidity. [Egypt J Neurol Psychiat Neurosurg.  2012; 49(2): 93-98]

 Key Words: Cerebellopontine Angle, Endoscopic Assisted Surgery, Vestibular Schwannomas, Trigeminal Neuralgia, and Microvascular Decompression.

 

Correspondence to Khaled Elsayed Mohamed, Neurosurgery Department, Seuz Canal University; Egypt.

Tel.: +201001851198   e-mail: khaledneuro@yahoo.com.

 





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