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Retrosigmoid approach for acoustic tumor removal
1Department of Otolaryngology, New York University School of Medicine, New York.
Otolaryngologic Clinics of North America
|April 1, 1992
Summary
The retrosigmoid approach offers wide cerebellopontine angle exposure for acoustic neuromas of all sizes. This technique allows for facial nerve visualization and successful hearing preservation in many cases.
Area of Science:
- Neurosurgery
- Cranial base surgery
Background:
- The retrosigmoid approach evolved from the traditional suboccipital operation.
- It provides wide exposure of the cerebellopontine angle when combined with internal auditory canal wall removal.
Purpose of the Study:
- To evaluate the efficacy of the retrosigmoid approach for acoustic neuroma resection.
- To assess hearing preservation and facial nerve outcomes with this technique.
Main Methods:
- Retrosigmoid surgical technique with posterior internal auditory canal wall removal.
- Application for acoustic neuromas ranging from intracanalicular to large (>4 cm).
- Attempted hearing preservation surgery and management of tumors >3 cm.
Main Results:
- Wide exposure of the cerebellopontine angle is achieved.
- Suitable for acoustic neuromas of all sizes.
- Hearing preservation is successful in a substantial minority of cases.
- Facial nerve is visualized with comparable risk to translabyrinthine operations.
Conclusions:
- The retrosigmoid approach is versatile for acoustic neuromas of all sizes.
- It facilitates hearing preservation and safe facial nerve management.
- This technique is recommended for hearing preservation surgery and large tumors.