[Is hearing preservation feasible with the retrosigmoid approach?]

The main advantages of the retrosigmoid approach are fast and good visualization of the brainstem structures and the possibility to remove tumors of all sizes. Hearing preservation, although possible, is not always achieved. The aim of this study is to present our experience with the retrosigmoid approach for acoustic neuroma resection, emphasizing our hearing results. The notes of 56 cases of acoustic neuroma removed through a the retrosigmoid approach were reviewed. Tumor size ranged from 8 to 50 mm (mean 24 mm). Considering patients with preoperative serviceable hearing, postoperative serviceable and measurable hearing was achieved in 13.3% and 26.7% of cases respectively. No tumor recurrence occurred in our series. The retrosigmoid approach is a reliable surgical procedure for most vestibular schwannoma. However, hearing preservation results may be unsatisfactory and show wide differences depending on selection criteria and the hearing terminology used. Concerns about hearing preservation should not be the deciding factor for using this approach.