TRANSPETROSAL REMOVAL OF AN ENDOLYMPHATIC SAC TUMOR WITH NEUROPHYSIOLOGICAL MONITORING

One of the rare neoplasms of the pyramid of the temporal bone is an endolymphatic sac tumor (ELST). The progression of the disease is characterized by an increase in neurological symptoms, including sensorineural hearing loss, facial nerve paresis, and headache. Neurosurgical tactics differ from standard methods of treating tumors because of the histoanatomical characteristics of ELST. This article describes a case of successful treatment of an endolymphatic sac tumor. Microsurgical removal of ELST is a best treatment, whereas radiosurgery has limited possibilities. This method used in the postoperative period with residual volumes of pathological tissue or tumor recurrence. We use retrolabyrinthine access with subtotal petrosectomy with neuronavigation and neurophysiological monitoring. Embolization of the vessels feeding the tumor was not performed before operation. Autohemotransfusion system, named Cell-Saver, and hemostatic materials were used intraoperatively. This method is safety and effectiveness, providing a relatively small amount of blood loss, complete decompression of intracranial structures, including the bulbar group of cranial nerves, partial - the VII and VIII pairs, which, however, was accompanied by regression of neurological symptoms and a satisfactory degree of resection of the tumor. This tactic can be recommended for the treatment of endolymphatic sac tumor, since there are lower risks of relapses and surgical complications for the patient.