Middle Cranial Fossa Acoustic Neuroma Excision: Results and Complications

Abstract

The middle cranial fossa surgical approach has been used for the removal of acoustic neuromas in 43 patients at the University of Iowa since 1974. Hearing was maintained in 50% of patients with tumors 1.5 cm or less outside the porus acusticus. Postoperative hearing, facial nerve function, and complications were similar to reports using the suboccipital or retrosigmoid approach to preserve hearing for this size tumor. The character of the tumor appears to dictate the postoperative outcome rather than the surgical approach.

Hearing Preservation With the Middle Cranial Fossa Approach for Neurofibromatosis Type 2

“…These outcomes compare favorably to facial nerve outcomes in patients with NF2 treated with stereotactic radiation therapy where facial nerve palsy rates range from 5% to 17% (27Y29). Furthermore, our outcomes are in agreement with previously reported facial nerve outcomes after surgical treatment of both sporadic and NF2-associated vestibular schwannomas (2,5,9,11). Among the study cohort, we did not find a correlation between tumor size or tumor volume and postoperative H-B facial nerve grade.…”

Contemporary Surgical Management of Vestibular Schwannomas

“…Any remaining deficits or symptoms after 12 to 24 months of follow-up were considered persistent deficits or complications. These complications included hearing loss in 44 (24.6%), FN palsies in 29 (7.3%; H-B III, 16 [4%]; IV-VI, 13 [3%]), disequilibrium in 26 (6.3%), bothersome tinnitus in 9 (2.2%), facial numbness in 9, chronic headache in 8 (2.0%), taste disturbance in 5 (1.2%), hydrocephalus in 4 (0.9%), cosmetic deformity that required cranioplasty in 4, facial synkinesis in 4, scar pain in 3 (0.7%), blepharospasm in 1 (0.2%), hemifacial spasm in 1, facial pain in 1, and tongue numbness in 1 (Table 5) patient.…”

Die Chirurgie des Kleinhirnbr�ckenwinkels

“…Meist wird die Liquorrhö innerhalb einer Woche postoperativ diagnostiziert,obwohl auch ein Auftreten mit einer Latenz von Jahren beschrieben ist [40].Es scheint kein Unterschied zwischen der Inzidenz einer Liquorrhö zwischen dem retrosigmoidalen und dem translabyrinthären Zugang zu bestehen. Die Inzidenz einer Liquorrhö nach retrosigmoidalem oder translabyrinthären Zugang variiert zwischen 7% und 21% [41,42,43,44,45,46].Eine Liquorrhö tritt jedoch signifikant seltener nach infratemporalem Zugang auf,hier ist ein Rate von 4-6% beschrieben [47,48]. Eine bakterielle Meningitis als Folge einer Liquorfistel kann in bis zu 25% der Fälle nachgewiesen werden [49] und entwickelt sich gewöhnlich innerhalb der ersten Tage nach Liquorrhö [49].…”