Surgery for endolymphatic sac tumor: whether and when to keep hearing?

Abstract

Conclusion. Endolymphatic sac tumors (ELSTs) are locally invasive, osteolytic, and hypervascular tumors. If the labyrinth has not been invaded, the hearing should be preserved in operation. Objective. To summarize three cases of ELST and discuss whether to keep hearing in the surgical treatment of ELST. Subjects and methods. Complete otorhinolaryngological examinations with audiologic, vestibular, and neurologic evaluations were performed. CT and MRI scans were carried out before operation and in the course of follow-up. The patients underwent radical removal of the tumor through a transmastoid approach and accepted postoperative radiotherapy. In two of them, the structure of the labyrinth and facial nerve were preserved in operation. Results. Histopathologic examinations agreed with features of an ELST. Patients suffered transitory vertigo shortly after operation, and so far, they are alive and well without further cranial nerve involvement. Case 3 patient has good hearing and facial nerve function now. No residual or recurrent tumor was detected on the postoperative MRI images.

• Endolymphatic sac tumor
• Meniere's disease
• osteolytic
• hypervascular
• facial nerve