title: The transmastoid retrolabyrinthine approach in vestibular schwannoma surgery.
abstract: OBJECTIVE
  We conducted a prospective analysis of 22 patients with small vestibular schwannoma and useful hearing who were operated on via a transmastoid retrolabyrinthine approach between January 1994 and March 1999.
  
  
  METHODS
  The average age was 35 years, and there were 14 females and 8 males. All patients had unilateral tumors, with 10 of them occurring in the right ear and 12 occurring in the left ear. The following parameters were included in our protocol: total removal of the tumor, intraoperative difficulties or complications, immediate postoperative complications, facial score 10 days and 3 months after the surgery, and audiologic evaluation 90 days after the surgery.
  
  
  RESULTS
  A good exposure of the internal auditory canal was possible in 19 cases. In 3 patients we had to change the approach to a translabyrinthine one to achieve total removal of the tumor in all patients. Hearing was preserved at the same preoperative levels in 31% of the cases.
  
  
  CONCLUSIONS
  The retrolabyrinthine approach offered security to the facial nerve, no morbidity, and good percentage of hearing preservation. It is also easily changeable to a translabyrinthine approach when more exposure is necessary.
authors.affiliation: Otolaryngology Department, University of São Paulo School of Medicine, Brazil. rbento@attglobal.net
authors.forename: Ricardo Ferreira
authors.initials: RF
authors.lastname: Bento
authors.forename: Rubens Vuono
authors.initials: RV
authors.lastname: De Brito
authors.forename: Tanit Ganz
authors.initials: TG
authors.lastname: Sanchez
authors.forename: Aroldo
authors.initials: A
authors.lastname: Miniti
mesh_terms: D000328:Adult; D001299:Audiometry; D007758:Ear, Inner / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D020220:Facial Nerve Injuries / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008416:Mastoid / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D009464:Neuroma, Acoustic / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology; D012720:Severity of Illness Index