Transmastoid Partial Labyrinthectomy for Brainstem Vascular Lesions: Clinical Outcomes and Assessment of Postoperative Cochleovestibular Function

See also: Commentary “Transmastoid Partial Labyrinthectomy for Brainstem Vascular Lesions: Clinical Outcomes and Assessment of Postoperative Cochleovestibular Function” Skull Base 2006; 16(03): 142-142 DOI: 10.1055/s-2006-949515 See also: Commentary “Transmastoid Partial Labyrinthectomy for Brainstem Vascular Lesions: Clinical Outcomes and Assessment of Postoperative Cochleovestibular Function” Skull Base 2006; 16(03): 142-143 DOI: 10.1055/s-2006-949516 ABSTRACT Objectives: To discuss the transmastoid partial labyrinthectomy approach for brainstem vascular lesions, with respect to hearing and balance preservation. Design: Retrospective case series. Setting: Tertiary referral center (University Health Network, Toronto). Participants: Nine consecutive surgical patients between 1999 and 2004. Main outcome measures: Clinical, audiometric, and electrophysiological vestibular data. Results: Nine transmastoid partial labyrinthectomy procedures (all females) were performed. In seven patients the underlying pathology was an intra-axial brainstem cavernous malformation. Two patients were treated for a basilar artery aneurysm. All patients had progressive neurological signs. Serviceable hearing (pure tone average (PTA): < 50 dB; speech discrimination score (SDS): > 50%) was preserved in seven patients. Partial vestibular function (clinical and electrophysiological) was maintained in most patients. Conclusions: The partial labyrinthectomy approach to the skull base provides excellent exposure while preserving cochleovestibular function in most patients. KEYWORDS Partial labyrinthectomy - labyrinthectomy - brainstem cavernoma - hearing preservation - vestibular function