TY - JOUR
T1 - Microsurgical Decompression of the Cochlear Nerve to Treat Disabling Tinnitus via an Endoscope-Assisted Retrosigmoid Approach
T2 - The Padua Experience
AU - Di Stadio, Arianna
AU - Colangeli, Roberta
AU - Dipietro, Laura
AU - Martini, Alessandro
AU - Parrino, Daniela
AU - Nardello, Ennio
AU - D'Avella, Domenico
AU - Zanoletti, Elisabetta
PY - 2018/5/1
Y1 - 2018/5/1
N2 - 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.
AB - 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.
KW - Hearing loss
KW - Loop
KW - Neurovascular conflict
KW - Retrosigmoid approach
KW - Surgical decompression
KW - Tinnitus
UR - http://www.scopus.com/inward/record.url?scp=85044040104&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044040104&partnerID=8YFLogxK
U2 - 10.1016/j.wneu.2018.02.105
DO - 10.1016/j.wneu.2018.02.105
M3 - Article
C2 - 29486316
AN - SCOPUS:85044040104
VL - 113
SP - 232
EP - 237
JO - World Neurosurgery
JF - World Neurosurgery
SN - 1878-8750
ER -