Acoustic neuroma management: a six-year review

The purpose of this investigation is to review the outcome of 83 consecutive acoustic neuroma patients, managed solely or in part by the Department of Otolaryngology at University Hospital, London, Ontario, over a 6-year period (1987 to 1993). The majority of patients underwent operative intervention, utilizing the middle cranial fossa, suboccipital, or most commonly, the translabyrinthine approach depending on the tumour size and level of residual hearing. Demographic, preoperative, intraoperative, and postoperative data are analyzed including complications of surgery. As well, we report on our experience with the use of fibrin glue in the dural closure following translabyrinthine resections and the resultant impact on the postoperative CSF leak rate. Overall, our results and complications are comparable to other large acoustic neuroma series in the literature. In addition, we feel that further study is merited in the use of fibrin glue in dural repair and its relationship to postoperative cerebrospinal fluid fistula.