Surgery by Dr. Juan Casado
Schwannoma surgery is a delicate procedure that requires a combination of precision and surgical expertise to preserve essential nerve functions. Dr. Juan Casado, an expert neurosurgeon with extensive experience in skull base surgeries, has performed a Schwannoma resection Hannover 4b in a fifty-year-old patient. This surgery, which can be seen in the surgical training app SurgSchool, offers an educational case of great value for neurosurgeons and otolaryngologists interested in the treatment of nerve tumors of the skull base.
Clinical case: Schwannoma Hannover 4b
This patient presented a bulky Schwannoma of classification Hannover 4b, located on the left side, with compression of the brain stem and distortion of the fourth ventricle. These tumors of nervous origin can compromise vital functions, such as hearing and facial motor skills, so surgical planning is essential to minimize the risk of sequelae.
Surgical strategies to preserve facial function
One of the highlights of the intervention of the Dr. Casado was his approach to preserving facial nerve function, a key concern in this type of surgery. The initial technique involved a Wide dissection of the arachnoid and cerebellum to obtain clear, tension-free access to the lesion.
After identifying the early facial nerve During surgery, Dr. Casado placed a ball-type electrode for continuous monitoring of the nerve. This approach allowed the nerve to be followed from the protuberance, minimizing the risk of damage during tumor resection.
Debulking and nerve preservation
El debulking (tumor volume reduction) was the next step in the surgery. With careful use of the aspirator and bipolar, Dr. Casado performed the removal of tumor tissue, maintaining the intact capsule to protect the facial nerve and the eighth cranial nerve, responsible for hearing.
Although the patient's hearing was already compromised, the primary goal was to avoid even transient facial paralysis. By proceeding with caution and keeping certain tumor adhesions minimal, the patient emerged from surgery without facial paralysis, with a classification of House Brackmann 1, which represents an almost complete preservation of facial function.
Internal auditory canal (IAC) opening technique
Another key point was the opening of the internal auditory canal (IAC) using diamond burs and laminotomes to expose the facial nerve and the eighth cranial nerve. Careful dissection allowed the removal of small tumor adhesions without compromising nerve function.
Conclusions
Resection of a Schwannoma Hannover 4b This is a complex surgical intervention that requires a multidisciplinary approach to preserve the patient's quality of life. Dr. Juan Casado demonstrated how a combination of continuous facial nerve monitoring, precise debulking and careful opening of the IAC can minimize the risk of complications in this type of tumor. This surgery is an excellent example of how advanced strategies in neurosurgery can be applied to obtain the best clinical results.
If you are a neurosurgeon or otolaryngologist and would like to learn more about Schwannoma resection techniques, We invite you to watch the full video of this surgery at SurgSchool. Gain access to quality training from internationally renowned experts and continue to expand your knowledge in the treatment of nervous system tumors.
