Microsurgical Decompression of the Cochlear Nerve to Treat Disabling Tinnitus via an Endoscope-Assisted Retrosigmoid Approach: The Padua Experience

Arianna Di Stadio, Roberta Colangeli, Laura Dipietro, Alessandro Martini, Daniela Parrino, Ennio Nardello, Domenico D'Avella, Elisabetta Zanoletti

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The use of surgical cochlear nerve decompression is controversial. This study aimed at investigating the safety and validity of microsurgical decompression via an endoscope-assisted retrosigmoid approach to treat tinnitus in patients with neurovascular compression of the cochlear nerve. Case Description: Three patients with disabling tinnitus resulting from a loop in the internal auditory canal were evaluated with magnetic resonance imaging and tests of pure tone auditory, tinnitus, and auditory brain response (ABR) to identify the features of the cochlear nerve involvement. We observed a loop with a caliber greater than 0.8 mm in all patients. Patients were treated via an endoscope-assisted retrosigmoid microsurgical decompression. After surgery, none of the patients reported short-term or long-term complications. After surgery, tinnitus resolved immediately in 2 patients, whereas in the other patient symptoms persisted although they improved; in all patients, hearing was preserved and ABR improved. Conclusion: Microsurgical decompression via endoscope-assisted retrosigmoid approach is a promising, safe, and valid procedure for treating tinnitus caused by cochlear nerve compression. This procedure should be considered in patients with disabling tinnitus who have altered ABR and a loop that has a caliber greater than 0.8 mm and is in contact with the cochlear nerve.

Original languageEnglish
Pages (from-to)232-237
Number of pages6
JournalWorld Neurosurgery
Volume113
DOIs
Publication statusPublished - May 1 2018

Keywords

  • Hearing loss
  • Loop
  • Neurovascular conflict
  • Retrosigmoid approach
  • Surgical decompression
  • Tinnitus

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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