title: [Extended middle fossa approach in treatment of vestibular schwannoma--technique of surgery and postoperative complications].
abstract: BACKGROUND
  The main tumor of cerebellopontine angle are vestibular schwannoma (80-90%). According to National Institute of Health Consensus Development Conference the best treatment method is microsurgery. There are three principal surgical approaches: translabyrinthin, retrosigmoid and middle fossa. Only the latter two approaches provide the possibility of hearing preservation.
  
  
  OBJECTIVE
  Technique of surgery and postoperative morbidity after MFA.
  
  
  METHODS
  39 patients (40 tumor) suffered from tumor of cerebellopontine angle, operated by using middle fossa approach in years 1998-2007. We evaluate hearing preservation and function of facial nerve and others postoperative morbidity.
  
  
  RESULTS
  22.5% of patients has hearing impairment and 32.5% has facial weakness. By individual cases we observed: CSF leak, meningitis, corneal ulceration, ischialgia, wound bleeding and venue thrombosis. 1/3 of patients suffered from headache and disequilibrium and 1/6 suffered from tinnitus.
  
  
  CONCLUSIONS
  According to NIH middle fossa approach is one of three possible approaches in microsurgery of cerebellopontine angle tumors. There is possible total tumor removal with hearing preservation. Monitoring of facial and cochlear nerve during operation is recommended.
authors.affiliation: Katedra i Klinika Otolaryngologii Warszawski Uniwersytet Medyczny SP CSK Banacha 1a. banco.biskup@op.pl
authors.forename: Barbara
authors.initials: B
authors.lastname: Jamróz
authors.forename: Kazimierz
authors.initials: K
authors.lastname: Niemczyk
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Morawski
authors.forename: Robert
authors.initials: R
authors.lastname: Bartoszewicz
mesh_terms: D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D002528:Cerebellar Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D002530:Cerebellopontine Angle / Q000473:pathology; D035301:Cranial Fossa, Middle / Q000601:surgery*; D005260:Female; D034381:Hearing Loss / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000379:methods*; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D011044:Poland / Q000453:epidemiology; D011183:Postoperative Complications / Q000453:epidemiology* / Q000523:psychology; D012189:Retrospective Studies; D016896:Treatment Outcome