Complications of translabyrinthine vs. suboccipital approach for acoustic tumor surgery

This study presents the operative results of surgeons with experience in both the translabyrinthine and suboccipital approaches to acoustic tumor removal for the purpose of resolving some of the controversy among centers favoring one approach over the other. The subjects were 171 patients with acoustic tumors who were treated at Virginia Mason Clinic from 1975 to 1986. The translabyrinthine approach was used in 64% of cases, the suboccipital approach in 35%, and the middle fossa approach in 1%. There were minor differences in morbidity and mortality between approaches. These data did not favor one approach over another. In an exploratory analysis, we found that the morbidity with a planned two-stage translabyrinthine-suboccipital removal was greater than the morbidity with a one-stage removal.