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[Removal of large acoustic neuroma via suboccipito-retrosigmoid approach with microsurgical technique]
1Neurosurgical Institute , People's Liberation Army, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.
Objective:
To probe the treatment effects of large acoustic neuroma (LAN) via a suboccipito-retrosigmoid microsurgical operation.
Methods:
216 patients with LAN in the cerebellar pons angle were confirmed by CT or MRI in our department. Each tumor (diameter > or = 31 mm) was removed via a suboccipito-retrosigmoid microsurgical approach. Treatment results were evaluated and the preoperative and postoperative function of the acoustic nerve or the facial nerve was compared separately.
Results:
The tumors were totally removed in 172 patients(79.6%), subtotally removed in 33 (15.3%), and partially removed in 11 (5.1%). Anatomic preservation of the acoustic nerve was achieved in 27 patients (12.5%), and functional preservation in 9 patients (Grade A, 4.2%) at discharge. Anatomic preservation of the facial nerve was achieved in 178 patients (82.4%) and functional preservation in 94 (House Grade, Grade I - II, 52.8%) at discharge. Follow-up observation (Median: 3.9 years) of 187 patients revealed good recovery in 128 patients (68.4%), fair recovery in 44 (23.5%), and poor recovery in 15 (8.0%). Late recurrence was noted in those with poor recovery (10 patients, 5.4%) (cured by second treatment).
Conclusions:
It is a safe and effective way to remove LAN via suboccipito-retrosigmoid approach with microsurgical technique.
