Preservation of hearing in large acoustic neurinomas following removal via suboccipito-lateral approach.
A consecutive series of 61 patients with pre-operative hearing underwent surgical removal of a large acoustic neurinoma via the lateral suboccipital approach between 1984 and 1996. Brain-stem auditory evoked potentials (BAEP) were present in all cases before surgery and all patients underwent intra-operative monitoring of BAEP. The average tumour size including the portion within the meatus acusticus internus was 30, 5 mm (range 20 mm-49 mm). Complete tumour removal was achieved in all but three cases. In 43.1% of patients with complete tumour removal hearing was preserved initially after surgery. Delayed postoperative hearing loss was observed in 11 patients and hearing recovery in 2 patients leading to 27.5% definite hearing preservation. Hearing preservation was achieved in 37% of cases with tumour size between 20 mm-29 mm and in 23.5% of case with tumour size larger than 30 mm. These results indicate that even in large neurinoms hearing preservation should be attempted in all patients with documented pre-operative hearing and BAEP.
Fahlbusch
R
R
Department of Neurosurgery, Friedrich-Alexander-University, Erlangen-Nürnberg, Germany.
Neu
M
M
Strauss
C
C
D000328:Adult; D000368:Aged; D001299:Audiometry; D003389:Cranial Nerve Diseases / Q000209:etiology; D016057:Evoked Potentials, Auditory, Brain Stem / Q000502:physiology; D005260:Female; D006309:Hearing / Q000502:physiology*; D006311:Hearing Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009464:Neuroma, Acoustic / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D009493:Neurosurgery / Q000379:methods; D011183:Postoperative Complications; D011184:Postoperative Period; D014057:Tomography, X-Ray Computed