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Acoustic neuroma.

B P Scrivener¹, J N Segelov

¹Royal Prince Alfred Hospital, Camperdown, NSW.

The Medical Journal of Australia

|December 2, 1991

Summary

This summary is machine-generated.

Improved imaging and surgical teams have significantly reduced mortality and improved facial nerve preservation in acoustic neuroma surgery. Early diagnosis leads to better outcomes for patients with these tumors.

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Area of Science:

Neurosurgery
Otolaryngology
Neurology

Background:

Acoustic neuromas, benign tumors arising from the vestibulocochlear nerve, require complex surgical management.
Historically, surgical removal presented significant risks of mortality and morbidity, including facial nerve damage and hearing loss.

Purpose of the Study:

To detail clinical features, diagnostic methods, and surgical techniques for acoustic neuroma removal.
To demonstrate reduced mortality and morbidity through improved imaging and a collaborative surgical team approach.

Main Methods:

Retrospective review of 106 patients (119 operations) for acoustic neuroma between 1977 and 1988.
Analysis of surgical approaches including posterior fossa craniectomy, translabyrinthine, middle cranial fossa, and retrosigmoid.

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Evaluation of outcomes including mortality, facial nerve function preservation, and tumor removal rates.

Main Results:

The retrosigmoid approach showed no mortality and 86% facial nerve function preservation.
Posterior fossa craniectomy had 9.5% mortality and 48% facial nerve preservation.
Translabyrinthine and middle cranial fossa approaches yielded higher mortality or no improvement in nerve function preservation.

Conclusions:

Advances in imaging and early diagnosis have improved surgical outcomes for acoustic neuromas.
A multidisciplinary neuro-otology team approach is crucial for enhancing surgical results, reducing mortality, and preserving neurological function, especially the facial nerve.