The lateral approach to acoustic tumors

The surgical experience of a decade of acoustic tumor surgery is discussed. This series involves 106 operations. A plea is made to use the "lateral" approach to the cerebellopontine angle which combines the translabyrinthine and retrosinal routes when necessary. The facial nerve is preserved in 88% of the patients using this approach and the mortality rate is only 1 or 2%. The most common complication is cerebrospinal fluid leakage. The posterior, suboccipital approach in acoustic tumors is condemned. Statistics are presented that make the argument of "hearing preservation" by suboccipital surgery academic. Only 11% of the patients in this series of 106 had "good" hearing preoperatively and all of these had normal hearing in the opposite ear.