| Title | Translabyrinthine removal of large acoustic neuromas. | | Author(s) | Briggs RJ, Luxford WM, Atkins JS, Hitselberger WE | | Institution | House Ear Clinic, Los Angeles, California. | | Source | Neurosurgery 1994 May; 34(5):785-90; discussion 790-1. | | MeSH | Adolescent
Adult
Aged
Aged, 80 and over
Audiometry, Pure-Tone
Blepharoptosis
Cerebellar Ataxia
Cranial Nerve Diseases
Cranial Nerve Injuries
Ear, Inner
Facial Nerve
Facial Paralysis
Female
Follow-Up Studies
Humans
Male
Microsurgery
Middle Aged
Neurologic Examination
Neuroma, Acoustic
Papilledema
Postoperative Complications
Retrospective Studies
Speech Discrimination Tests
Treatment Outcome
| | Abstract | Several surgical approaches to the cerebellopontine angle and internal auditory canal have been developed for the removal of acoustic neuromas. The choice of an approach may be influenced by hearing levels and tumor size. We reviewed the records of the primary translabyrinthine removal of 167 large (> or = 4 cm) acoustic neuromas performed between 1982 and 1990. Patients ranged in age from 15 to 83 years, with a mean of 43 years (male, 49%; female, 51%). Total removal was achieved in 95%. The facial nerve was preserved anatomically intact in 91%. At follow-up (mean, 2.1 yr), facial nerve function was acceptable (Grades I-IV) in 75% and good (Grades I-II) in 42%. Vascular complications occurred in 4.8%; however, there were no deaths. A cerebrospinal fluid leak occurred in 9.6% of cases, and meningitis occurred in 8.3%. In patients with large tumors where there is little chance to preserve preoperative hearing, we have successfully used the translabyrinthine approach for total tumor removal. The advantages and disadvantages of both the translabyrinthine and suboccipital approaches are discussed. | | Language | eng | | Pub Type(s) | Journal Article
| | PubMed ID | 8052375 |
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