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Surgical management of endolymphatic sac tumor: classification, outcomes and strategy. A single institution’s experience

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To review the resections of endolymphatic sac tumor (ELST) and describe our experience in the surgical management of ELST.

Methods

Retrospective investigation of consecutive patients who underwent resection of ELSTs at our hospital between 1999 and 2019. The symptoms, diagnosis, surgical findings, and outcomes were analyzed to develop a tumor staging system and corresponding surgical strategy.

Results

Retrospective review revealed the surgical treatment of 22 ELSTs. Based on intraoperative findings of tumor extent and size, ELSTs were classified into two types. Type-I (n = 6) referred to the small tumors that were locally confined with limited invasion of semicircular canals and dura; type-II (n = 16) referred to the large tumors that presented extensive erosion of at least one anatomic structure apart from the semicircular canals and the dura around endolymphatic sac. In this case series, Type-I ELST is amenable to resection through a transmastoidal approach, and subtotal petrosectomy is appropriate for the resection of type-II ELST. Sensorineural hearing loss (SNHL) is the most commonly preoperative symptom in both two types of cases. Five type-II ELSTs experienced recurrence and underwent reoperation, whereas all type-I ELSTs did not.

Conclusion

ELST usually results in SNHL (95%) at the time of diagnosis. The surgical strategy and prognosis of ELST resections are different between type-I and type-II: type-I ELST is amenable to transmastoidal approach with the preservation of facial nerve, whereas type-II ELST increase the surgical difficulty and the risk of recurrence, and subtotal petrosectomy is the basic requirement for the resection of type-II ELST.

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Abbreviations

ELST:

Endolymphatic sac tumor

SNHL:

Sensorineural hearing loss

yr:

Year

NRT:

Neural response telemetry

CSF:

Cerebrospinal fluid

H–B:

House–Brackmann

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Funding

This study was supported by grant from Innovative Research Group Project of the National Natural Science Foundation of China (81820108009).

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Author notes

  1. **aoyan Ma and Nan Wu contributed equally to this work.

Authors and Affiliations

  1. Senior Department of Otolaryngology-Head & Neck Surgery, The Sixth Medical Center of PLA General Hospital, Bei**g, China

    Nan Wu, **aoyan Ma, Weidong Shen, Zhaohui Hou, Weiju Han, Pu Dai, Hui Zhao, Deliang Huang, Dongyi Han & Shiming Yang

  2. National Clinical Research Center for Otolaryngologic Diseases, Bei**g, China

    Nan Wu, **aoyan Ma, Weidong Shen, Zhaohui Hou, Weiju Han, Pu Dai, Hui Zhao, Deliang Huang, Dongyi Han & Shiming Yang

  3. State Key Lab of Hearing Science, Ministry of Education, Bei**g, China

    Nan Wu, **aoyan Ma, Weidong Shen, Zhaohui Hou, Weiju Han, Pu Dai, Hui Zhao, Deliang Huang, Dongyi Han & Shiming Yang

  4. Bei**g Key Lab of Hearing Impairment Prevention and Treatment, Bei**g, China

    Nan Wu, **aoyan Ma, Weidong Shen, Zhaohui Hou, Weiju Han, Pu Dai, Hui Zhao, Deliang Huang, Dongyi Han & Shiming Yang

  5. The First Affiliated Hospital of **’an Jiaotong University, **’an, Shaanxi, China

    **aoyan Ma

  6. Department of Otolaryngology, Head and Neck Surgery, Institute of Otolaryngology, Chinese PLA General Hospital, 28 Fu **ng Road, Bei**g, 100853, China

    Dongyi Han

Authors
  1. Nan Wu
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Corresponding author

Correspondence to Dongyi Han.

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The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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Wu, N., Ma, X., Shen, W. et al. Surgical management of endolymphatic sac tumor: classification, outcomes and strategy. A single institution’s experience. Eur Arch Otorhinolaryngol 280, 69–76 (2023). https://doi.org/10.1007/s00405-022-07447-y

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  • DOI: https://doi.org/10.1007/s00405-022-07447-y

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