Intracapsular Enucleation for Vagal and Sympathetic Chain Schwannomas

Résumé fourni par la source

Objective: This article aims to describe the surgical technique of intracapsular enucleation as method of resection of vagal schwannomas; to introduce a new classification system for vagal schwannomas to allow postoperative morbidity to be predicted; and to compare the postoperative morbidity of intracapsular enucleation to traditional nerve sacrificing techniques. Materials and Methods: We present a discussion of the operative technique as used in our institution; classification of vagal schwannomas in view of their radiological position, appearance, and distance from the skull base; retrospective view of all intracapsular enucleations for vagal schwannomas performed within one tertiary skull base center: classification, intraoperative challenges, postoperative morbidity, and residual or recurrent disease. Conclusion: Intracapsular enucleation is a safe and effective method for the removal of vagal schwannomas. The morbidity associated with the technique is significantly less than traditional nerve sacrificing methods, without an increased rate of residual or recurrent disease. The risk of postoperative morbidity can be predicted by classifying vagal schwannoma types using preoperative imaging. Publication History Article published online: 07 February 2025 © 2025. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

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