title: Middle fossa approach for hearing preservation with acoustic neuromas.
abstract: OBJECTIVE
  This study aimed to provide a clinical review of middle fossa approach for hearing preservation in acoustic neuroma surgery.
  
  
  METHODS
  This was a prospective case review.
  
  
  METHODS
  The study was performed in a tertiary referral center of a private otologic practice.
  
  
  METHODS
  One hundred fifty-one consecutive middle fossa approaches for removal of acoustic neuroma were used. The 91 males and 60 females ranged in age from 10-72 years with a mean age of 48 years. Tumor size ranged from 0.5-2.5 cm, with a mean of 1.2 cm.
  
  
  METHODS
  House-Brackmann facial nerve grade and hearing level classified both by the American Academy of Otolaryngology-Head and Neck Surgery criteria for reporting results of hearing preservation surgery and by comparison with preoperative level (15 dB/15%) were the main outcome measures.
  
  
  RESULTS
  Measurable hearing was preservation in 68%, with 52% within 15 dB and 15% discrimination. Excellent facial function (House-Brackmann grade I-II) was obtained in 95% of patients.
  
  
  CONCLUSIONS
  The middle fossa craniotomy approach for acoustic neuroma is a reliable approach with a good hearing preservation rate and excellent facial nerve function outcome. Complications are minimal in this group of patients.
authors.affiliation: House Ear Clinic, Los Angeles, California, USA.
authors.forename: W H
authors.initials: WH
authors.lastname: Slattery
authors.forename: D E
authors.initials: DE
authors.lastname: Brackmann
authors.forename: W
authors.initials: W
authors.lastname: Hitselberger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D002648:Child; D003399:Craniotomy / Q000379:methods*; D016057:Evoked Potentials, Auditory, Brain Stem; D005154:Facial Nerve / Q000502:physiology; D005260:Female; D006311:Hearing Disorders / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009464:Neuroma, Acoustic / Q000150:complications / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011446:Prospective Studies; D000159:Vestibulocochlear Nerve / Q000473:pathology / Q000601:surgery*