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Conclusion: Middle fossa approach (MFA) shows a hearing preservation rate of 86% and facial nerve function was preserved with HB grade I or II in 93%. MFA is a good treatment option for intra-canalicular vestibular schwannomas when surgical excision is needed. Background: Surgical outcomes of vestibular schwannoma have progressively improved with the advancement of microsurgical instruments. MFA is known to have better chances to preserve hearing, while it has limited access to the posterior fossa, limitation of tumor size, and higher risk of post-operative facial nerve weakness. Objectives: To investigate surgical outcomes and clinical efficiency of MFA in vestibular schwannoma. Methods: A retrospective study was done in 14 patients who underwent MFA for vestibular schwannoma in Asan Medical Center. Results: The median age at diagnosis was 46.3 years. At initial presentation, 57% of the patients had vertigo, 43% hearing disturbance, and 64% tinnitus. The mean tumor size was 9.7 mm. The tumors were completely resected in 86% of the patients. Hearing was post-operatively preserved in 12 patients and two patients lost their hearing following surgery. Facial nerve function post-operatively remained unchanged in 12 patients (86%). [ABSTRACT FROM AUTHOR]

Background/aims: Little is known about the effects of periodic endoscopic screening before detection of primary gastric cancer. We compared clinical outcomes in patients who did and did not undergo endoscopy before diagnosis., Methods: Between January 2009 and November 2011, 769 patients were referred to Asan Medical Center after diagnosis of gastric cancer. Clinical outcomes were compared in patients who had (n=512) and had not (n=257) undergone endoscopic screening before diagnosis of gastric cancer. Factors about resectability and possibility of endoscopic resection were analyzed., Results: In the nonexamined group, 225 patients (87.5%) had resectable gastric cancers and were treated surgically (n=151, 67.1%) or by endoscopic resection (n=74, 32.9%). In the examined group, 493 (96.3%) had resectability and were resected surgically (n=243, 49.3%) or endoscopically (n=250, 50.7%). Multivariate analysis showed that symptoms, no endoscopic screening, and lower serum albumin were associated with unresectability. Of the 718 resectable tumors, 394 underwent surgery and 324 underwent endoscopic resection. Multivariate analysis showed that older age, no symptoms, ≤1 year interval endoscopy, and higher serum albumin were associated with endoscopic resection., Conclusions: Previous endoscopy can increase gastric cancer resectability. Moreover, a ≤1 year interval from endoscopic examination can increase the possibility of endoscopic resection.