Middle fossa decompression of the internal auditory canal in acoustic neuroma surgery: a therapeutic alternative.
Unilateral acoustic neuromas in only-hearing ears and bilateral acoustic neuromas (NF-2) are separate entities, but both pose a common problem because surgical removal has the potential to leave the patient totally deafened. A middle fossa decompression of the internal auditory canal (IAC) was performed in 8 patients (5 with NF-2 tumors and 3 with neuromas in an only-hearing ear). In 5 of the 8, the speech discrimination scores at the 6-month follow-up were better than preoperative scores. After 6 months, however, hearing regressed at variable rates. Although not a definitive therapeutic treatment, decompression of the IAC appears to improve and perhaps prolong useful hearing, which gains valuable time for rehabilitation. Rigid follow-up by computed tomography scans or magnetic resonance imaging is essential.
House Ear Institute, Los Angeles, CA.
A K
AK
Gadre
J A
JA
Kwartler
D E
DE
Brackmann
W F
WF
House
W E
WE
Hitselberger
D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D013063:Speech Discrimination Tests; D013069:Speech Reception Threshold Test; D013701:Temporal Bone / Q000601:surgery