[Preservation of hearing and facial nerve function in surgery for acoustic neuroma]

The results concerning the preservation of hearing and facial nerve function in 71 patients with 74 acoustic neuromas operated on from 1979 to 1990 are presented. All patients have been operated on in half-sitting position by one surgeon using the suboccipital-transmeatal approach. Postoperative facial nerve function was good (House degree I or degrees II) in 42/73 patients (58%), moderate (House degrees III or degrees IV) in 13/37 (18%), and poor (House degrees V or degrees VI) in 18/73 (24%). Preservation of useful hearing was achieved in 17%. The smaller the tumour and the easier the preparation the better was the functional result. Beside anatomic integrity of nerves and endolymphatic system the internal auditory artery as the most important vessel for the inner ear blood supply should be respected. The cochlear nerve intact in 47 patients we only found one case with recurrent tumour in a patient with neurofibromatosis 2. Preservation of the cochlear nerve did not have an increased risk of tumour recurrence in our group of patients.