Introduction: Some groups in the world start using endoscope for vestibular schwannoma, with promising results.
Methods: Retrospective meta-analysis.
Inclusion Criteria:
–Case series with > 20 adult patients
–Endoscopic or open resection
–Retrosigmoid approach
–Adults
–English language.
Exclusion Criteria:
–Other approaches: translabyrinthine, middle fossa
–Animal, cadaver, and basic science studies
–Comparative studies.
Results: 1861 articles,44 articles included with 48.5% agreement level. After review, 25 articles: 4 endoscopic and 21 open. Total population: 3026 for open, 790 for endoscopic. Tumor size was not significantly different between the two groups. Good facial outcome (House and Brackmann I or II) was more in the endoscopic group (94 vs. 67%). Better cochlear nerve function, less CSF leak, more GTR all were more seen in endoscopic group too.
Conclusions: Although we don’t have the strongest methods of evidence, but at least we can say: endoscopic is not inferior to standard open approach. With expert hand; endoscopic can offer result as good as open, with potential benefits, such as: less pain and shorten length of stay in hospital. There is a need for more control studies for definitive comparison. We acknowledge the limitations in our study which include:
•Heterogeneity.
•Many information not available.
•Different definitions.
•Cross population between some studies
•This is a summation of case series.
Patient Care: by studying the role of endoscope in VS, which might offer a less invasive approach and better visualization, with help for more total resection and avoiding complication
Learning Objectives: To determine whether patient outcomes and complications differ depending on surgical approach of either endoscopic or open resection methods for the removal of Vestibular Schwannoma. The primary Outcome: rate of facial nerve preservation. Secondary Outcomes: CSF leak, Vestibular nerve preservation, tumour size, degree of resection, wound infection, recurrence rate, and death