title: [Facial nerve function and hearing preservation experience in middle fossa approach removal of small acoustic tumor surgery].
abstract: OBJECTIVE
  The aim of this study was to investigate the hearing and facial nerve preservation in the middle fossa approach surgery for the removal of small acoustic tumor (vestibular schwannomas, VS).
  
  
  METHODS
  A prospective database was established, and data were retrospectively reviewed. Between January 2004 and February 2013, 13 patients with acoustic tumor underwent surgery via middle fossa approach for hearing preservation. The patients consisted of six men and seven women with a mean age of 48 years. Tumor size ranged from 0.8 cm to 1.5 cm. Hearing loss was categorized as American Academy of Otolaryngology Head and Neck Surgery (AAO-HNS) class A, class B, class C and class D. Facial nerve function was evaluated according to House-Brackmann (HB) Grade I-VI.
  
  
  RESULTS
  Gross-total resection was accomplished in 12 of 13 patients. Preoperative hearing as class A in ten, class B in two, and class C in one patient respectively. Postoperatively, hearing was graded as class A in eight patients, class B in 3, and class C in 2 patients. Facial nerve function was House-Brackmann (HB) grade I in twelve patients, grade II in one patient preoperatively. Postoperatively, facial nerve function was HB Grade I in twelve patients and Grade III in one patient. The overall hearing preservation rate was at least 80% (8/10) and HB Grade I facial nerve outcome of 100% (12/12) . All cases were followed up for 0.5 to 5 years, no complications were observed.
  
  
  CONCLUSIONS
  The middle fossa approach for the resection of small VS with hearing preservation is a viable and relatively option. It should be considered among the various options available for the management of small and growing VS.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, First People's Hospital of Yangzhou, Yangzhou 225001, China.
authors.forename: Jue-bo
authors.initials: JB
authors.lastname: Yu
authors.forename: Hao
authors.initials: H
authors.lastname: Wu
authors.forename: Qi
authors.initials: Q
authors.lastname: Huang
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China. Email:otology-xinhua@hotmail.com.
authors.forename: Jun
authors.initials: J
authors.lastname: Yang
authors.forename: Zhao-yan
authors.initials: ZY
authors.lastname: Wang
authors.forename: Jing-rong
authors.initials: JR
authors.lastname: Lü
mesh_terms: D000328:Adult; D035301:Cranial Fossa, Middle / Q000601:surgery*; D005154:Facial Nerve / Q000502:physiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome