50 yr old male with Nonserviceable hearing loss on right side.Diagnosis and Management.

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vestibular schwanoma need surgery by reterosigmoid approach. Gamma knife radiation should not be done as brain stem is already under pressure which will further increase by radiation. I am a neurosurgeon who does SRS also.

Acoustic Neuroma.. Trans labyrinthine or Retro sigmod approach for Surgical removal.. Trans Lab prefered as there is no serviceable hearing. We can save Facial nerve in better way.. This approach we can reach upto CP angle also and have complete clearance. This n Retro sigmod approach are preferred by Prof Mario Sanna.. Piacenza Italy.

sir...the tumour is quite big and encroaching the brainstem. a non sevicable hearing loss is not that important in this case as is the size and extent of tumour. we need a wide exposure whinch can be acheived on by a retrosigmoid approach. so in my opinion sir, with due respect and considering the benefit of the patient, it has to be a retrosigmoid approach
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As correctly pointed out,we can either use retrosigmoid or translabyrinthine. Surgeon preference is one thing.Nonserviceable hearing makes translabyrinthine more tempting,but more common and comfortable is retrosigmoid.Results are comparable.

most probably acoustic schwanoma. nonservicable hearing loss. mri s/o compression over fourth ventricle and brain stem . so operation should be treatment of choice. retromastoid would be best approach depending upon NEUROSURGEON experience

yes stereotactic radio surgery is not at all an option here as Dr manish was saying. as the tumour will definitely have post radiation edema. and brain stem compression will occur.

Vestibular schwanoma. Treatment is with sterotactic gamma knife surgery.

gamma knife isn't an option here
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vestibular shwannoma. we now approaching this by 2cm retrosigmoid burrhole, and commbined otology-neuro endoscopic approach

Vestibular schwanoma. Treatment is with sterotactic gamma knife surgery.

most probable diagnosis vestibular schwannoma..... tumor looks greater than 3 cm in dimensions....and with non serviceable hearing.... therefore translabyrinthine approach will be best..... other approaches are 1)rectosigmoid approach 2)middle cranial fossa approach

sorry it's retrosigmoid approach...not rectosigmoid
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treatment depends on size 2to3 cm gamma knife &more surgery

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