Use of a compact high-definition two-dimensional exoscope in surgical treatment of large vestibular schwannoma.

ABSTRACT: BACKGROUND:Extra-corporeal video telescope operating monitor system provides a necessary instrument to perform high-precision neurosurgical procedures that could substitute or supplement the traditional surgical microscope. The present study was designed to evaluate a compact high-definition two-dimensional exoscope system for assisting in surgical removal of large vestibular schwannoma (VS), as an alternative to a binocular surgical microscope. METHODS:Patients with Koos grade 3 and grade 4 VS undergoing surgery were enrolled in this prospective cohort study between January 2013 and June 2018. The demographics and tumor characteristics (size, Koos grade, composition [cystic or solid mass]) were matched between the two groups of patients. The following outcome measurements were compared between the two groups: duration of surgery, volume of blood loss, extent of tumor resection, number of operating field adjustments, pre- and post-operative facial and cochlear nerve function evaluated at 3 months post-surgery, complications and surgeons' comfortability. RESULTS:A total of 81 patients received tumor resection through the retrosigmoid approach under either an exoscope (cases, n?=?39) or a surgical microscope (control, n?=?42). Patients in the two groups had comparable tumor location (P?=?0.439), Koos grading (P?=?0.867), and composition (P?=?0.891). While no significant differences in the duration of surgery (P?=?0.172), extent of tumor resection (P?=?0.858), facial function (P?=?0.838), and hearing ability (P?=?1.000), patients operated on under an exoscope had less blood loss (P?=?0.036) and a fewer field adjustments (P?

SUBMITTER: Chen X 

PROVIDER: S-EPMC7289312 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature