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  1. Irfan Mohamad, Arumugam, Puvan Arul, Nik Fariza Husna Nik Hassan
    MyJurnal
    An 11-year-old Malay boy was allegedly involved in motor vehicle accident. He sustained left lung contusion and pneumothorax which necessitate chest tube insertion at a district hospital. On arrival at Accident & Emergency Unit, general physical examination was performed. Neck examination revealed multiple jagged lacerations wound on the left side of the neck (Panel 1). (Copied from article).
  2. Tengku Kamalden TMI, Misron K, Arumugam PA
    Acta Otolaryngol, 2021 Jul;141(7):678-683.
    PMID: 33908813 DOI: 10.1080/00016489.2021.1916074
    BACKGROUND: With more intracanalicular vestibular schwannoma (ICVS) diagnosed, treatment options are limited either to wait-and-see or surgery. The transpromontorial and infrapromontorial approaches allow direct route to the fundus of internal auditory canal with certain advantages in preserving facial nerve and even cochlear nerve.

    OBJECTIVES: To describe the middle ear corridor approach for ICVS excision.

    METHODOLOGY: All transpromontorial and infrapromontorial approaches for ICVS excision were recruited. The surgeries were performed at an otologic center by a single experienced otologist.

    RESULTS: Three cases of ICVS Koos Type I were included in this review. Two cases were operated with exclusive endoscopic transcanal transpromontorial approach excision of tumor. One case underwent concurrent transcanal excision of ICVS through infrapromontorial approach with cochlear implantation. Two of them developed facial nerve paresis. The last patient recovered fully with viable cochlear nerve enabling hearing restoration with cochlear implant.

    CONCLUSION: The potential of surgery in ICVS via middle ear approach is a safe and direct route with promising outcome. This approach offers removal of the ICVS without interrupting facial and cochlear nerves. Hence, the preservation of facial function and hearing are possible.

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