Exo- and endoscopic two-step approach for recurrent vestibular schwannomas following surgical resection and radiosurgery: How I do it

Intracanalicular residual vestibular schwannoma (VS) after surgical resection is known to cause recurrence. Lesions demonstrating progression despite adjuvant stereotactic radiosurgery necessitate salvage surgery with meticulous tumour resection to prevent recurrence. We describe our exo- and endoscopic two-step approach (EETA), employing an exoscope to remove the extracanalicular component and an endoscope to remove the intracanalicular component under direct visualisation of the fundus. EETA is a viable option for treating recurrent VS, as it enables enhanced visualisation of both extra- and intracanalicular lesions, including the fundus.