Abstract：
There are several surgical approaches for vestibular schwannoma (VS) resection. However, management has gradually shifted from microsurgical resection, toward surveillance and radiosurgery. One of the arguments against microsurgery via the middle fossa approach (MFA) is the risk of temporal lobe retraction injury or sequelae. Here, we sought to evaluate the incidence of temporal lobe retraction injury or sequela from a MFA via a systematic review of the existing literature. This systematic review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Relevant studies reporting temporal lobe injury or sequela during MFA for VS were identified. Data was aggregated and subsequently analyzed to evaluate the incidence of temporal lobe injury. 22 studies were included for statistical analysis, encompassing 1522 patients that underwent VS resection via MFA. The overall rate of temporal lobe sequelae from this approach was 0.7%. The rate of CSF leak was 5.9%. The rate of wound infection was 0.6%. Meningitis occurred in 1.6% of patients. With the MFA, 92% of patients had good facial outcomes, and 54.9% had hearing preservation. Our series and literature review support that temporal lobe retraction injury or sequelae is an infrequent complication from an MFA for intracanalicular VS resection.
摘要：
前庭神经鞘瘤（VS）切除术有几种手术方法。然而,管理已经逐渐从显微外科手术转移，监视和放射外科。反对通过中窝入路（MFA）进行显微手术的论点之一是颞叶回缩损伤或后遗症的风险。这里,我们试图通过对现有文献的系统回顾,评估MFA所致颞叶牵拉损伤或后遗症的发生率.本系统评价是根据系统评价和荟萃分析（PRISMA）指南的首选报告项目进行的。确定了在VS的MFA期间报告颞叶损伤或后遗症的相关研究。汇总数据并随后进行分析以评估颞叶损伤的发生率。22项研究被纳入统计分析，包括1522例通过MFA接受VS切除术的患者。该方法的颞叶后遗症的总发生率为0.7％。脑脊液渗漏率为5.9%。伤口感染率为0.6%。1.6%的患者发生脑膜炎。有了MFA,92%的患者面部效果良好，54.9%有听力保留。我们的系列和文献综述支持颞叶回缩损伤或后遗症是听管内VS切除MFA的罕见并发症。
