Neuroendoscopy applications in vestibular schwannoma resection

The vestibular schwannoma (VS) originates from the Schwann cells of the vestibular nerve myelin. For patients with growing tumors or cysts and/or clinical symptoms such as hearing loss, surgical treatment is indicated. VS treatment strategy has shifted from total tumor resection to maximal tumor resection with the preservation of nerve function. With the remarkable development of endoscopic surgery in the past 20 years, an increasing number of surgeons have begun to pursue endoscopically assisted or total endoscopic resection of VS,and have achieved remarkable clinical results. VS treatment has become more minimally invasive and better aligned with clinical needs. This article primarily focused on the application of neuroendoscopy in VS resection, including its use in different surgical approaches, such as retrosigmoid sinus approach (RSA), translabyrinthine approach (TLA), middle cranial fossa approach (MFA) and transauricular capsule approach, and also summarized the necessity and extent of drilling the posterior wall of the internal auditory meatus (IAC) during the RSA. Furthermore,the paper discussed the role of neuroendoscopy in the protection of facial and cochlear nerve function during VS operations. Finally, this study reviewed the effects of neuroendoscopy on the presence of residual VS and its limitations. The aim was to explore prospects for the application of neuroendoscopy in VS resection. • Review of neuroendoscopy's role in multi-approach VS surgery for nerve preservation. • Presents neuroendoscopy effectiveness and limitations for VS treatment. • Neuroendoscopy for VS improves visualization,benefits nerve preservation, reduces complications.