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Microvascular Decompression and Transposition of the 8th Cranial Nerve Using a Fenestrated Clip
Journal Pre-proof Microvascular Decompression and Transposition of the 8 Fenestrated Clip
th
Cranial Nerve Using a
Evelyn L. Turcotte, BS, Devi P. Patra, MD, MCh, Karl R. Abi-Aad, MD, Matthew E. Welz, MS, Peter A. Weisskopf, MD, Bernard R. Bendok, MD, MSCI PII:
S1878-8750(19)33075-X
DOI:
https://doi.org/10.1016/j.wneu.2019.12.046
Reference:
WNEU 13893
To appear in:
World Neurosurgery
Received Date: 28 October 2019 Revised Date:
7 December 2019
Accepted Date: 9 December 2019
Please cite this article as: Turcotte EL, Patra DP, Abi-Aad KR, Welz ME, Weisskopf PA, Bendok BR, th Microvascular Decompression and Transposition of the 8 Cranial Nerve Using a Fenestrated Clip, World Neurosurgery (2020), doi: https://doi.org/10.1016/j.wneu.2019.12.046. This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2019 Published by Elsevier Inc.
Microvascular Decompression and Transposition of the 8th Cranial Nerve Using a Fenestrated Clip Evelyn L. Turcotte, BS1,4,5, Devi P. Patra, MD, MCh1,4,5, Karl R. Abi-Aad, MD1,4,5, Matthew E. Welz, MS1,4,5, Peter A. Weisskopf, MD2, Bernard R. Bendok, MD, MSCI1,2.3,4,5 1
Department of Neurological Surgery, Mayo Clinic, Phoenix, AZ.
2
Department of Otolaryngology, Mayo Clinic, Phoenix, AZ.
3
Department of Radiology, Mayo Clinic, Phoenix, AZ.
4
Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, AZ.
5
Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, AZ.
Corresponding Author: Bernard R. Bendok, MD MSCI Chair, Department of Neurological Surgery William J. and Charles H. Mayo Professor Mayo Clinic, Phoenix, AZ 85054 Email: [email protected] Phone: 480-342-4889 Fax: 480-342-3699 Disclosures None Conflict of Interest None
Microvascular Decompression and Transposition of the 8th Cranial Nerve Using a Fenestrated Clip Abstract: Neurovascular compression is a potential, yet rare cause of vertigo and unilateral tinnitus. Despite the high success rate of microvascular decompression (MVD) in other vascular compression syndromes, the outcome reported after MVD of the vestibulocochlear nerve is variable.1,2 The presence of combined symptoms of tinnitus and vertigo treated by MVD has demonstrated a higher predictive value for success.3 In this video, we present the case of a 68-year-old male who presented with vertigo and tinnitus refractory to medical management and vestibular therapy. Audiologic evaluation was normal apart from mild sensorineural hearing loss. The vestibular testing was suggestive of uncompensated right peripheral vestibulopathy. Magnetic resonance imaging (MRI) with Fast Imaging Employing Steady-state Acquisition (FIESTA) sequences revealed vascular compression by the right anterior-inferior cerebellar artery (AICA) at the cisternal component of vestibulocochlear nerve. After a multi-disciplinary discussion, a microvascular decompression was performed through a right retrosigmoid craniotomy. The AICA was mobilized off the vestibulocochlear nerve and was secured to the petrous dura using a fenestrated clip. Indocyanine green (ICG) angiography with Glow-800 was conducted before and after AICA transposition to confirm adequate flow through the mobilized vessel. Postoperatively, the patient’s vestibular symptoms improved significantly. This case demonstrates that microvascular decompression can provide a satisfactory outcome in patients with unilateral tinnitus and vertigo associated with vascular compression in appropriately selected cases.
References: 1. Yap, L., Pothula, V. B., & Lesser, T. (2008). Microvascular decompression of cochleovestibular nerve. European Archives of Oto-Rhino-Laryngology, 265(8), 861-869. 2. Zhang, L., Yu, Y., Yuan, Y., Xu, J., Xu, X., & Zhang, J. (2012). Microvascular decompression of cochleovestibular nerve in patients with tinnitus and vertigo. Neurology India, 60(5), 495. 3. Van Den Berge, M. J., van Dijk, J. M. C., Posthumus, I. A., Smidt, N., van Dijk, P., & Free, R. H. (2017). Microvascular decompression of the cochleovestibular nerve for treatment of tinnitus and vertigo: a systematic review and meta-analysis of individual patient data. Journal of neurosurgery, 127(3), 588-601.
th
Cranial Nerve Using a
Evelyn L. Turcotte, BS, Devi P. Patra, MD, MCh, Karl R. Abi-Aad, MD, Matthew E. Welz, MS, Peter A. Weisskopf, MD, Bernard R. Bendok, MD, MSCI PII:
S1878-8750(19)33075-X
DOI:
https://doi.org/10.1016/j.wneu.2019.12.046
Reference:
WNEU 13893
To appear in:
World Neurosurgery
Received Date: 28 October 2019 Revised Date:
7 December 2019
Accepted Date: 9 December 2019
Please cite this article as: Turcotte EL, Patra DP, Abi-Aad KR, Welz ME, Weisskopf PA, Bendok BR, th Microvascular Decompression and Transposition of the 8 Cranial Nerve Using a Fenestrated Clip, World Neurosurgery (2020), doi: https://doi.org/10.1016/j.wneu.2019.12.046. This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. © 2019 Published by Elsevier Inc.
Microvascular Decompression and Transposition of the 8th Cranial Nerve Using a Fenestrated Clip Evelyn L. Turcotte, BS1,4,5, Devi P. Patra, MD, MCh1,4,5, Karl R. Abi-Aad, MD1,4,5, Matthew E. Welz, MS1,4,5, Peter A. Weisskopf, MD2, Bernard R. Bendok, MD, MSCI1,2.3,4,5 1
Department of Neurological Surgery, Mayo Clinic, Phoenix, AZ.
2
Department of Otolaryngology, Mayo Clinic, Phoenix, AZ.
3
Department of Radiology, Mayo Clinic, Phoenix, AZ.
4
Precision Neuro-therapeutics Innovation Lab, Mayo Clinic, Phoenix, AZ.
5
Neurosurgery Simulation and Innovation Lab, Mayo Clinic, Phoenix, AZ.
Corresponding Author: Bernard R. Bendok, MD MSCI Chair, Department of Neurological Surgery William J. and Charles H. Mayo Professor Mayo Clinic, Phoenix, AZ 85054 Email: [email protected] Phone: 480-342-4889 Fax: 480-342-3699 Disclosures None Conflict of Interest None
Microvascular Decompression and Transposition of the 8th Cranial Nerve Using a Fenestrated Clip Abstract: Neurovascular compression is a potential, yet rare cause of vertigo and unilateral tinnitus. Despite the high success rate of microvascular decompression (MVD) in other vascular compression syndromes, the outcome reported after MVD of the vestibulocochlear nerve is variable.1,2 The presence of combined symptoms of tinnitus and vertigo treated by MVD has demonstrated a higher predictive value for success.3 In this video, we present the case of a 68-year-old male who presented with vertigo and tinnitus refractory to medical management and vestibular therapy. Audiologic evaluation was normal apart from mild sensorineural hearing loss. The vestibular testing was suggestive of uncompensated right peripheral vestibulopathy. Magnetic resonance imaging (MRI) with Fast Imaging Employing Steady-state Acquisition (FIESTA) sequences revealed vascular compression by the right anterior-inferior cerebellar artery (AICA) at the cisternal component of vestibulocochlear nerve. After a multi-disciplinary discussion, a microvascular decompression was performed through a right retrosigmoid craniotomy. The AICA was mobilized off the vestibulocochlear nerve and was secured to the petrous dura using a fenestrated clip. Indocyanine green (ICG) angiography with Glow-800 was conducted before and after AICA transposition to confirm adequate flow through the mobilized vessel. Postoperatively, the patient’s vestibular symptoms improved significantly. This case demonstrates that microvascular decompression can provide a satisfactory outcome in patients with unilateral tinnitus and vertigo associated with vascular compression in appropriately selected cases.
References: 1. Yap, L., Pothula, V. B., & Lesser, T. (2008). Microvascular decompression of cochleovestibular nerve. European Archives of Oto-Rhino-Laryngology, 265(8), 861-869. 2. Zhang, L., Yu, Y., Yuan, Y., Xu, J., Xu, X., & Zhang, J. (2012). Microvascular decompression of cochleovestibular nerve in patients with tinnitus and vertigo. Neurology India, 60(5), 495. 3. Van Den Berge, M. J., van Dijk, J. M. C., Posthumus, I. A., Smidt, N., van Dijk, P., & Free, R. H. (2017). Microvascular decompression of the cochleovestibular nerve for treatment of tinnitus and vertigo: a systematic review and meta-analysis of individual patient data. Journal of neurosurgery, 127(3), 588-601.