Analysis of the results obtained in 120 patients with large acoustic neuromas surgically treated via the translabyrinthine-transtentorial approach.
OBJECTIVE
The authors review the results of a series of 120 acoustic neuromas that were surgically treated via the translabyrinthine-transtentorial approach between 1986 and 1999.


METHODS
The authors retrospectively evaluated a series of 120 acoustic neuromas with extrameatal diameters of 2 cm or greater, 99 (82.5%) of which had diameters longer than 3 cm. Complete tumor removal, as ascertained using computerized tomography or magnetic resonance imaging, was achieved in 110 patients (91.7%). The facial nerve was anatomically preserved in 97 patients (80.8%). The main postoperative complications were cerebrospinal fluid (CSF) leakage through the scalp wound (13.3%) requiring surgical revision in 2.5%, meningitis (9.2%), CSF rhinorrhea (6.7%) requiring surgical revision in 2.5%, and epileptic seizures (the only permanent complication) requiring medication (3.3%). There was no death directly related to the surgery. Long-term follow-up examination of the facial nerve revealed recovery of function to the level of House-Brackmann Grade I or II in 56.2% of the patients.


CONCLUSIONS
The results and complications presented in this series are comparable to those reported in the literature. The authors conclude that the combined translabyrinthine-transtentorial approach is a safe route for removing acoustic neuromas with a diameter of 2 cm or greater.
Sluyter
S
S
Department of Otorhinolanryngology and Neurosurgery, Utrecht University Medical Center, The Netherlands.
Graamans
K
K
Tulleken
C A
CA
Van Veelen
C W
CW
D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use; D002531:Cerebellum; D002555:Cerebrospinal Fluid / Q000378:metabolism*; D002559:Cerebrospinal Fluid Rhinorrhea / Q000209:etiology / Q000601:surgery; D007758:Ear, Inner; D004827:Epilepsy / Q000188:drug therapy / Q000209:etiology; D005154:Facial Nerve / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008582:Meningitis, Aseptic / Q000209:etiology / Q000601:surgery; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D019635:Neurosurgical Procedures; D011183:Postoperative Complications; D011184:Postoperative Period; D012189:Retrospective Studies; D012535:Scalp / Q000378:metabolism* / Q000601:surgery; D016896:Treatment Outcome
D000927:Anticonvulsants