Combined presigmoid retrolabyrinthine and retrosigmoid approach for large vestibular schwannoma: a case report

The retrosigmoid approach is widely used for vestibular schwannoma resection. If the tumor is large, significant cerebellar retraction may be required, which can cause cerebellar edema. The presigmoid retrolabyrinthine route preserves the labyrinth and reduces cerebellar retraction and manipulation but provides only a narrow surgical corridor....

No practice change warranted from a single case report; the combined presigmoid retrolabyrinthine and retrosigmoid approach is a technique option for experienced skull-base teams managing large vestibular schwannomas, but comparative outcomes data are lacking.

Minimising cerebellar retraction during large vestibular schwannoma surgery may reduce surgical morbidity, and documenting novel combined approaches adds to the surgical technique literature for skull-base teams.

1. 01A combined presigmoid retrolabyrinthine and retrosigmoid approach was used to resect a large vestibular schwannoma.
2. 02The dual approach was intended to reduce cerebellar retraction compared with single-corridor techniques.
3. 03Vestibular schwannomas are benign tumors of the hearing/balance nerve that can cause progressive hearing loss and balance problems.
4. 04Case reports of novel surgical approaches help build the evidence base but cannot establish superiority over existing techniques alone.
5. 05Facial nerve and hearing preservation outcomes in large tumors remain a key challenge regardless of surgical approach.

PMID

42199887

DOI

10.3389/fsurg.2026.1817241.

Journal

Frontiers in Surgery

Publication type

case_report

Evidence level

4

Sample size

1

Population

Individual patient with a large vestibular schwannoma

Intervention

Combined presigmoid retrolabyrinthine and retrosigmoid surgical approach for vestibular schwannoma resection