Just came across this and thought those with ANs confined to the IAC might find it of interest. The surgery is being done in South Korea. It will not save hearing, all patients had severe hearing loss pre-op. But it appears to be a 3 hour operation that does not require drilling through the skull. The surgeries were done in 2016 and 2017, so there has been 1 year of follow up. Can’t help but wonder if there has been regrowth in any cases. Apparently there was no damage to the facial nerve, but the don’t mention balance issues.
J Neurol Surg B Skull Base. 2019 Feb;80(1):82-87. doi: 10.1055/s-0038-1667061. Epub 2018 Jul 30.
The Feasibility of a Modified Exclusive Endoscopic Transcanal Transpromontorial Approach for Vestibular Schwannomas.
Moon IS1, Cha D1, Nam SI2, Lee HJ3, Choi JY1.
Objective We evaluated the feasibility of an exclusive endoscopic transcanal transpromontorial approach (EETTA) for the treatment of small vestibular schwannomas (VSs) limited to the internal auditory canal (IAC), and introduced a modification without external auditory canal closure. Methods Between June 2016 and June 2017, seven patients with VS underwent surgery using a modified EETTA. Treatment outcomes, including efficacy of tumor resection, preservation of function, operation time, and quality of life (QOL), were evaluated. Results The patients preoperatively exhibited Koos Grade I/II tumors and severe-to-profound hearing loss. Gross total resection was accomplished in all cases. There were no major complications, and all patients exhibited normal facial nerve function immediately after surgery. The mean follow-up period was 12.9 months. The operation time (average 196.3 ± 64.9 minutes) and hospitalization period (average 7.4 ± 1.0 days) were favorable. Short Form-36 scores for QOL showed unremarkable results compared with previous reports. Conclusions The modified EETTA was effective in the removal of VSs in the IAC. It can be an alternative surgical option for small VSs.