{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T18:04:10Z","timestamp":1786125850904,"version":"build-2736575974"},"reference-count":5,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T00:00:00Z","timestamp":1619740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Medial acoustic tumors are a rare distinct type of vestibular schwannoma having distinguished clinical and radiological features.\n                    <jats:sup>1<\/jats:sup>\n                    Originating medially in the cerebellopontine angle without extending into the lateral internal auditory meatus, they are frequently giant in size at presentation in younger patients with a relatively preserved hearing, while they have other neurological deficits from cerebellar or brainstem compression and associated hydrocephalus. Imaging typically shows a cystic tumor with local mass effect and an internal auditory canal filled with cerebrospinal fluid.\n                    <jats:sup>1,2<\/jats:sup>\n                    Surgical resection of theses schwannoma is particularly challenging not only due to their size and hypervascularity, but also given their particular arachnoidal rearrangement inducing marked adherence to the brainstem and facial nerve.\n                    <jats:sup>2<\/jats:sup>\n                  <\/jats:p>\n                  <jats:p>\n                    \u2003The treatment is surgical resection, despite, however, their giant size hearing preservation should be sought and is attainable.\n                    <jats:sup>1\u20135<\/jats:sup>\n                    Transmastoid approach with squeletonization and reflection of the transverse sigmoid sinus provides lateral exposure avoiding cerebellar retraction.\n                    <jats:sup>6<\/jats:sup>\n                    In this report, we demonstrate the specific surgical considerations applied to the resection of a giant medial acoustic tumor in a 40-yr-old patient presenting with ataxia, vertigo, facial paresthesia, and intact hearing. The patient agreed to the surgery and photography.\n                  <\/jats:p>\n                  <jats:p>\n                    \u2003Image at 1:44 \u00a9 Ossama Al-Mefty, used with permission; Image at 8:21 from Dunn et al,\n                    <jats:sup>2<\/jats:sup>\n                    used with permission from JNSPG.\n                  <\/jats:p>","DOI":"10.1093\/ons\/opab129","type":"journal-article","created":{"date-parts":[[2021,4,30]],"date-time":"2021-04-30T14:47:35Z","timestamp":1619794055000},"page":"E101-E102","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Medial Acoustic Tumors: Special Considerations: 2-Dimensional Operative Video"],"prefix":"10.1227","volume":"21","author":[{"given":"Rami O","family":"Almefty","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Temple University, Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4640-0563","authenticated-orcid":false,"given":"Walid Ibn","family":"Essayed","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ossama","family":"Al-Mefty","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2021,8]]},"reference":[{"issue":"2","key":"bib1-20250821","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1001\/archotol.1992.01880020019009","article-title":"Medial acoustic neuromas. A new clinical entity","volume":"118","author":"Tos","year":"1992","journal-title":"Arch Otolaryngol Head Neck Surg"},{"issue":"5","key":"bib2-20250821","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.3171\/2014.1.JNS131701","article-title":"Medial acoustic neuromas: clinical and surgical implications","volume":"120","author":"Dunn","year":"2014","journal-title":"J Neurosurg"},{"issue":"4","key":"bib3-20250821","doi-asserted-by":"crossref","first-page":"684","DOI":"10.1097\/00006123-199704000-00006","article-title":"Management of 1000 vestibular schwannomas (acoustic neuromas): the facial nerve\u2013preservation and restitution of function","volume":"40","author":"Samii","year":"1997","journal-title":"Neurosurgery"},{"issue":"3","key":"bib4-20250821","doi-asserted-by":"crossref","first-page":"821","DOI":"10.3171\/2014.12.JNS142826","article-title":"Letter to the editor: save the nerve","volume":"123","author":"Upadhyay","year":"2015","journal-title":"J Neurosurg"},{"issue":"1 Suppl Operative","key":"bib6-20250821","first-page":"ons16","article-title":"Transmastoid retrosigmoid approach to the cerebellopontine angle: surgical technique","volume":"73","author":"Abolfotoh","year":"2013","journal-title":"Neurosurgery"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/21\/2\/E101\/38923602\/opab129.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opab129","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:03:21Z","timestamp":1786122201000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opab129"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,30]]},"references-count":5,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opab129","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,4,30]]},"assertion":[{"value":"2021-01-18","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-02-23","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}