Racial considerations in acoustic neuroma removal with hearing preservation via the retrosigmoid approach

Racial differences in the size, shape and structure of the cranium exist. This paper evaluates the importance of race in influencing the required sizes of craniotomies for gaining access to the lateral end of the internal auditory meatus without breaching the labyrinth via the retrosigmoid approach. Fine-cut CT scans of the temporal bones (axial cuts) of 34 Chinese and 34 Europeans were studied. The relevant distances and angles of the posterior cranial fossa and temporal bone were measured and statistically significant differences between the two races were found. This led us to the conclusion that a larger craniotomy is required in Europeans than in Chinese. In recommending an optimal size for a retrosigmoid craniotomy to remove acoustic neuromas completely and preserve hearing, the racial factor must be considered.