title: [Results in the surgical treatment of giant acoustic neuromas].
abstract: OBJECTIVE
  To compare the results obtained in the resection of 21 giant vestibular schwannomas via retrosigmoid (RS) and combined retrosigmoid/translabyrinthine (RS/TL) approaches with respect to intra- and postoperative complications, facial nerve preservation and postsurgical sequelae.
  
  
  METHODS
  This was a retrospective study of 21 patients who underwent a resection of a giant vestibular neuroma according to the Tos & Thomsen Scale (greater than or equal to 4 centimetres) in a tertiary care centre in the period between 2000 and 2008. We present the most significant characteristics of the series studied and the analysis of the advantages and inconveniences of each approach. We also analyse the results regarding facial nerve function preservation.
  
  
  RESULTS
  We highlight the absence of mortality in the 21-patient group. There were no important intraoperative complications. Total resection of the lesion was achieved in the 87% of the cases, with facial nerve preservation of 73% using the combined RS/TL approach, in comparison to 40% using the RS. Facial nerve function after two years was acceptable or good in 67% (including those with heteronerve anastomosis). A global percentage of 14.3% of cerebrospinal liquid fistula was observed, as well as 9.5% of meningitis.
  
  
  CONCLUSIONS
  The results of the study demonstrate that the combined retrosigmoid translabyrinthine approach for giant schwannoma treatment offers increased facial nerve preservation and lower morbidity, constituting an important option in the treatment of this kind of tumours thanks to a multidisciplinary approach.
authors.affiliation: Servicio Otorrinolaringología, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España. ninesgk@hotmail.com
authors.forename: Ana Inés
authors.initials: AI
authors.lastname: Giordano
authors.forename: Ivan
authors.initials: I
authors.lastname: Domènech
authors.forename: Alberto
authors.initials: A
authors.lastname: Torres
authors.forename: Javier
authors.initials: J
authors.lastname: Skufca
authors.forename: Angela
authors.initials: A
authors.lastname: Callejo
authors.forename: Laura
authors.initials: L
authors.lastname: Palomino
authors.forename: Alberto
authors.initials: A
authors.lastname: Aparicio
authors.forename: Josefina
authors.initials: J
authors.lastname: Junyent
authors.forename: Manuel
authors.initials: M
authors.lastname: Mañós
mesh_terms: D000328:Adult; D000368:Aged; D020220:Facial Nerve Injuries / Q000517:prevention & control; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D046088:Hearing Loss, Unilateral / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D007431:Intraoperative Complications / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D016518:Neurofibromatosis 2 / Q000601:surgery; D009464:Neuroma, Acoustic / Q000150:complications / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D047368:Tumor Burden; D055815:Young Adult