神经鞘瘤
前庭系统
切除术
颅骨
医学
经迷路入路
工作流程
计算机科学
外科
放射科
数据库
磁共振成像
桥小脑角
作者
Hugo Layard Horsfall,Danyal Z. Khan,Justin Collins,Stephen Cooke,Simon Freeman,Nihal Gurusinghe,Susie Hampton,Carl Hardwidge,Richard Irving,Neil Kitchen,Andrew King,Sherif Khalil,Chan Hee Koh,Colin Leonard,Hani J. Marcus,William Muirhead,Rupert Obholzer,Omar Pathmanaban,Iain Robertson,Jonathan Shapey,Danail Stoyanov,Mario Teo,James R. Tysome,Patrick Grover,Shakeel Saeed
出处
期刊:Journal of neurological surgery
[Georg Thieme Verlag KG]
日期:2022-10-10
卷期号:84 (05): 433-443
被引量:1
标识
DOI:10.1055/s-0042-1755578
摘要
Abstract Objective An operative workflow systematically compartmentalizes operations into hierarchal components of phases, steps, instrument, technique errors, and event errors. Operative workflow provides a foundation for education, training, and understanding of surgical variation. In this Part 2, we present a codified operative workflow for the translabyrinthine approach to vestibular schwannoma resection. Methods A mixed-method consensus process of literature review, small-group Delphi's consensus, followed by a national Delphi's consensus was performed in collaboration with British Skull Base Society (BSBS). Each Delphi's round was repeated until data saturation and over 90% consensus was reached. Results Seventeen consultant skull base surgeons (nine neurosurgeons and eight ENT [ear, nose, and throat]) with median of 13.9 years of experience (interquartile range: 18.1 years) of independent practice participated. There was a 100% response rate across both the Delphi rounds. The translabyrinthine approach had the following five phases and 57 unique steps: Phase 1, approach and exposure; Phase 2, mastoidectomy; Phase 3, internal auditory canal and dural opening; Phase 4, tumor debulking and excision; and Phase 5, closure. Conclusion We present Part 2 of a national, multicenter, consensus-derived, codified operative workflow for the translabyrinthine approach to vestibular schwannomas. The five phases contain the operative, steps, instruments, technique errors, and event errors. The codified translabyrinthine approach presented in this manuscript can serve as foundational research for future work, such as the application of artificial intelligence to vestibular schwannoma resection and comparative surgical research.