Cooperative neuro-otologic management of acoustic neuromas and other cerebellopontine angle tumors.
Over a recent 16-month period, 35 cerebellopontine angle tumors were removed at our institution by a surgical team consisting of one neurosurgeon and one otologist. Nineteen tumors were less than 2 cm in diameter and six were greater than 4 cm. There were 26 acoustic neuromas, six meningiomas, two epidermoid tumors, and a glossopharyngeal schwannoma. A suboccipital transmeatal approach was used in the majority of patients. There were no deaths. Thirty-two patients had an excellent outcome. Twenty-four patients had complete tumor removal (92% of the acoustic neuromas). The facial nerve was preserved anatomically in all but one patient, who had nerve grafting intraoperatively and has partial recovery of function. Thirteen of the 24 patients who had auditory function retained some of it postoperatively. With current diagnostic techniques, combined with the neurosurgical and otologic team approach, the majority of patients with acoustic tumors of all sizes may expect a complete resection of the tumor with a good outcome. Certainly, early diagnosis and resection of smaller tumors will increase the likelihood that hearing will be preserved, thus providing impetus for aggressive diagnostic and surgical treatment of patients with these lesions.
Kelly
D L
DL
Department of Surgery, Bowman Gray School of Medicine, Wake Forest University Medical Center, Winston-Salem, NC 27103.
Britton
B H
BH
Branch
C L
CL
D000293:Adolescent; D000328:Adult; D000368:Aged; D002528:Cerebellar Neoplasms / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D002530:Cerebellopontine Angle; D002781:Cholesteatoma / Q000000981:diagnostic imaging / Q000601:surgery; D003390:Cranial Nerve Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D005154:Facial Nerve / Q000503:physiopathology; D005260:Female; D005930:Glossopharyngeal Nerve; D006309:Hearing; D006801:Humans; D008297:Male; D008577:Meningeal Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery; D008579:Meningioma / Q000000981:diagnostic imaging / Q000601:surgery; D008722:Methods; D008875:Middle Aged; D009442:Neurilemmoma / Q000000981:diagnostic imaging / Q000601:surgery; D009464:Neuroma, Acoustic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed