[Acoustic neurinomas. Trans-labyrinthine approach (author's transl)].
The authors, supporters of a tight oto-neuro-surgical collaboration, show their tactical evolution in front of acoustic neurinomas which they operated at first in two stages, trans-labyrinthine then sub-occipital, and now they approach only by trans-labyrinthine way. They report their experience and their results to the point of a first serie of 30 cases : 10 combined approaches in two stages, and 20 trans-labyrinthine approaches. The mortality (3 cases-10%) for this first serie is still raised. One patient, after a softening of the pons, maintained important sequelles. On the other hand, among the remaining 26 patients, 13 kept a normal facial motricity and 5 recovered but with syncinesis. These first results are still perfectible : among the 20 last cases only trans-labyrinthine approached the facial nerve preservation was realised in 72% of the cases. The most frequent surgical complication is a cerebro-spinal fluid leak (7 cases) which fortunately the most often spontaneously dry up (6 cases) but which justify a very attentive closure technic. The authors show the arguments which convinced them of the interest of the trans-labyrinthine approach such it is done by W. House.
D000328:Adult; D002555:Cerebrospinal Fluid; D007758:Ear, Inner / Q000601:surgery*; D005260:Female; D005402:Fistula / Q000209:etiology; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D011183:Postoperative Complications
La collaboration oto-neuro-chirurgicale dans l'abord trans-labyrinthique des neurinomes de l'acoustique.