Case Series: A 5-year-experience ofTranslabyrinthine Approach in Managing Cerebellopontine Angle Tumour in Ministry of Health Malaysia
Translabyrinthine Approach for Schwannoma
Abstract
Vestibular schwannomas (VS) are benign tumours of vestibular branch of vestibulocochlear nerve, originated from the glial cells that form the myelin sheaths. The tumours account for 6% to 10% of all intracranial tumours and 60% to 90% of cerebellopontine angle (CPA) tumours. This article described our experience in managing CPA tumour via translabyrinthine approach in the setting of Ministry of Health in Malaysia, with multidisciplinary team involvement. We discussed the demographics, common clinical presentation, histopathology of the CPA tumour, hospital stays and complications. There were 26 surgeries performed from 2018 until 2022, whereby a total of 18 (69.2%) patients were female, and 8(30.8%) were male. The mean age of the patients was 49.35 + 13.39. From a total of 26 patients, 19 (69.2%) had a normal post-operative facial nerve function. However, a total of 7 patients (30.8%) suffered from permanent facial nerve palsy ranging from House-Brackmann grade II to grade IV. Our data revealed that four (15.4%) patients sustained cerebrospinal leak. The total duration of hospital stays ranged from 5 days to 51 days with median of 8.5 and interquartile range (IQR) of 5.75. Acoustic neuroma surgery via translabyrinthine approach is a safe and compelling treatment. The interdisciplinary concept is recommended as each step of the operation requires specialist expertise.
Keywords :
Interdisciplinary; translabyrinthine; vestibular schwannoma,
Abstrak
Vestibular schwannomas' (VS) juga dikenali sebagai neuromas akustik, adalah tumor jinak pada cabang vestibular saraf kranial kelapan dan berasal daripada sel Schwann yang melapisi cawangan vestibular. Tumor ini menyumbang kepada 6-10% daripada semua tumor intrakranial dan 60-90% daripada tumor sudut 'cerebellopontine' (CPA). Artikel ini menerangkan pengalaman kami dalam mengendalikan tumor CPA melalui pendekatan 'translabyrinthine' dalam konteks Kementerian Kesihatan Malaysia, dengan penglibatan pasukan pelbagai disiplin. Kami membincangkan demografi, persembahan klinikal biasa, histopatologi tumor CPA, penginapan di hospital dan komplikasi. Terdapat 26 pembedahan telah dijalankan dari tahun 2018 hingga 2022, di mana seramai 18 (69.2%) pesakit adalah wanita, dan 8 (30.8%) adalah lelaki. Purata umur pesakit ialah 49.35 + 13.39. Daripada 26 pesakit, 19 (69.2%) mempunyai fungsi saraf muka selepas pembedahan yang normal. Walau bagaimanapun, seramai 7 pesakit (30.8%) mengalami kelumpuhan saraf muka kekal dari House-Brackmann gred II hingga gred IV. Data kami menunjukkan bahawa empat (15.4%) pesakit mengalami kebocoran cecarir serebrospinal. Tempoh penginapan hospital adalah antara 5 ke 51 hari, dengan median 8.5 dan julat antara kuartil (IQR) 5.75. Pembedahan neuroma akustik melalui pendekatan 'translabyrinthine' ialah rawatan yang selamat dan berkesan. Konsep pembedahan saraf/ENT antara disiplin disarankan kerana setiap langkah operasi memerlukan kepakaran yang khusus.
Kata Kunci :
Interdisiplin; 'schwannoma vestibular'; 'translabyrinthine',
Correspondance Address
Dr Wan Nabila Wan Mansor. Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Kuala Lumpur, Malaysia. Tel: +603-9145 6045 Email: wannabila.wanmansor@ukm.edu.my
