Vascular Preservation In Vestibular Schwannoma Surgery

Résumé

Background: A 65-year-old male patient, JM, with a medical history of diabetes and hypertension presented with a longstanding history of progressive left-sided hearing loss, occipital headaches, and abnormal gait over the last six months. Examination revealed ataxic gait, requiring support, reduced hearing in the left ear with a false negative Rinne's test, and a right-lateralized Weber's test. Pure tone audiometry (PTA) indicated profound sensorineural hearing loss. Objective: To evaluate the clinical presentation and diagnostic findings in a patient with a vestibular schwannoma and to highlight the importance of vascular preservation during surgical management. Methods: A comprehensive clinical examination and audiological assessment were conducted. Imaging studies, including MRI, were utilized to confirm the diagnosis of a left-sided vestibular schwannoma. Surgical intervention focused on the meticulous preservation of vascular structures to prevent complications and ensure optimal postoperative outcomes. Results: The patient successfully underwent surgery with careful preservation of critical vascular structures. Postoperative evaluation demonstrated improved stability and a reduction in headache severity. Audiological outcomes remained consistent with preoperative findings, underscoring the chronic nature of the sensorineural hearing loss. Conclusion: Vascular preservation in vestibular schwannoma surgery is crucial for minimizing complications and enhancing patient recovery. Detailed preoperative planning and precision in surgical technique are essential for successful outcomes, particularly in patients with complex medical histories.