Analysis of the results obtained in 120 patients with large acoustic neuromas surgically treated via the translabyrinthine-transtentorial approach

• Published in: Journal of neurosurgery Vol. 94; no. 1; p. 61
• Main Authors: Sluyter, S, Graamans, K, Tulleken, C A, Van Veelen, C W
• Format: Journal Article
• Language: English
• Published: United States 01.01.2001
• Subjects: Adult; Aged; Anticonvulsants - therapeutic use; Cerebellum; Cerebrospinal Fluid - metabolism; Cerebrospinal Fluid Rhinorrhea - etiology; Cerebrospinal Fluid Rhinorrhea - surgery; Ear, Inner; Epilepsy - drug therapy; Epilepsy - etiology; Facial Nerve - physiopathology; Female; Humans; Male; Meningitis, Aseptic - etiology; Meningitis, Aseptic - surgery; Middle Aged; Neuroma, Acoustic - surgery; Neurosurgical Procedures; Postoperative Complications; Postoperative Period; Retrospective Studies; Scalp - metabolism; Scalp - surgery; Treatment Outcome
• ISSN: 0022-3085
• DOI: 10.3171/jns.2001.94.1.0061

The authors review the results of a series of 120 acoustic neuromas that were surgically treated via the translabyrinthine-transtentorial approach between 1986 and 1999. The authors retrospectively evaluated a series of 120 acoustic neuromas with extrameatal diameters of 2 cm or greater, 99 (82.5%) of which had diameters longer than 3 cm. Complete tumor removal, as ascertained using computerized tomography or magnetic resonance imaging, was achieved in 110 patients (91.7%). The facial nerve was anatomically preserved in 97 patients (80.8%). The main postoperative complications were cerebrospinal fluid (CSF) leakage through the scalp wound (13.3%) requiring surgical revision in 2.5%, meningitis (9.2%), CSF rhinorrhea (6.7%) requiring surgical revision in 2.5%, and epileptic seizures (the only permanent complication) requiring medication (3.3%). There was no death directly related to the surgery. Long-term follow-up examination of the facial nerve revealed recovery of function to the level of House-Brackmann Grade I or II in 56.2% of the patients. The results and complications presented in this series are comparable to those reported in the literature. The authors conclude that the combined translabyrinthine-transtentorial approach is a safe route for removing acoustic neuromas with a diameter of 2 cm or greater.