Advantages of the enlarged middle cranial fossa approach in acoustic neurinoma surgery. A review.
Utilizing an enlarged middle cranial fossa approach to the cerebello-pontine angle without destruction of the labyrinth or cochlea the authors have since 1981 operated on 263 unilateral acoustic neurinomas. Tumour sizes ranged between 3 mm intrameatal and 35 mm within the cerebello-pontine angle. Complete tumour removal was accomplished in 96%. There was one postoperative mortality, and only rarely neurological complications. Excellent function of the facial nerve was obtained in 78% (in small and medium sized neurinomas 90% House I and II) and severe paralysis persisted in only 6%. Preservation of hearing was possible in 70% of the small tumours, and in 50% of the total group. Against this background comparable data of the literature are reviewed, and the indications for the enlarged midfossa approach analyzed.
Haid
C T
CT
Department of Oto-Rhino-Laryngology, University of Erlangen-Nuremburg, Germany.
Wigand
M E
ME
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003638:Deafness / Q000601:surgery; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005154:Facial Nerve / Q000473:pathology / Q000503:physiopathology; D006309:Hearing / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009464:Neuroma, Acoustic / Q000473:pathology / Q000601:surgery*; D010579:Petrous Bone / Q000294:innervation; D011183:Postoperative Complications; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000473:pathology; D012886:Skull / Q000473:pathology / Q000601:surgery*; D000159:Vestibulocochlear Nerve / Q000473:pathology / Q000503:physiopathology