This case-based technical video report demonstrates microsurgical resection of a vestibular schwannoma in a high-risk pneumatized temporal bone anatomy. A 38-year-old woman with non-serviceable hearing and preserved facial nerve function underwent surgery for a 20 x 13-mm Koos grade III vestibular schwannoma....
No actionable change for audiologists — this is a neurosurgical technique video report of interest primarily to skull-base surgeons, though audiologists counseling patients on vestibular schwannoma surgical outcomes should be aware that highly pneumatized temporal bones present elevated CSF leak risk.
Technical innovations in vestibular schwannoma surgery directly affect patient hearing and vestibular outcomes, making awareness of evolving surgical approaches relevant to audiologists involved in pre- and post-operative care.
- 01Case report details microsurgical resection of vestibular schwannoma in a highly pneumatized (air-cell-rich) temporal bone.
- 02A fat graft was used to prevent cerebrospinal fluid (CSF) leakage, a known surgical complication.
- 03Highly pneumatized temporal bones increase the technical difficulty and CSF leak risk.
- 04The report is accompanied by a technical video, offering surgical education value.
- 05Evidence is limited to a single case; findings cannot be generalized.
Fat graft-assisted CSF leak prevention is a viable technique for vestibular schwannoma resection in highly pneumatized temporal bones.
studypartially supported- PMID
- 42229842
- DOI
- 10.1016/j.wneu.2026.125090.
- Journal
- World Neurosurgery
- Publication type
- case_report
- Evidence level
- 4
- Sample size
- 1
- Population
- Single patient with vestibular schwannoma in a highly pneumatized temporal bone
- Intervention
- Microsurgical vestibular schwannoma resection with fat graft-assisted CSF leak prevention
Primary outcomes
Successful tumor resection; Prevention of cerebrospinal fluid leak