The enlarged translabyrinthine removal of large acoustic neuromas: 18 cases report
10.3969/j.issn.1001-1781.2000.10.001
- VernacularTitle:扩大迷路进路切除大听神经瘤18例报告
- Author:
Hao WU
;
Shuimiao ZHOU
;
Zhaoji LI
;
Suqin ZHANG
- Publication Type:Journal Article
- Keywords:
Acoustic neuroma Operative surgery Translabyrinthine approach Facial nerve
- From:
Journal of Clinical Otorhinolaryngology Head and Neck Surgery
2000;(10):435-437
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the surgical methods and results of enlarged translabyrinthine approachin the removal of large acoustic neuromas. Method:A large mastoidectomy involved complete exposure of sigmoidsinus, the dura behind the sinus for at least lcm, the superior petrosal sinus and the middle fossa dura. Thejugular bulb was exposed and pressed downwards if necessary. The internal auditory meatus was skeletonizedand uncovered for at least 270°. The debulking of the tumor began inside the anterior and inferior poles in orderto find the brainstem and the facial nerve root as early as possible, then the dissection of the nerve was performedmedially to laterally. Intraoperative facial nerve monitoring and postoperative CT and MRI were performed in allcases. Result:Total removal was achieved in all 18 patients with tumors larger than 3 cm (mean size:4.2 cm).There were no death as well as other complications such as intracranial infection and persistent cerebrospinalfluid leakage. There were no obvious cerebral sequela. The facial nerve was preserved both anatomically andfunctionally in 14 cases, with Grade Ⅰ or Ⅱ in 8 cases,Grade Ⅲ or Ⅳ in 6 cases. Nerve interruption occurred in4 cases who all had severe facial paralysis or nerve interruption before operation. 16 patients returned to workwithin 1～3 months. Conclusion: Total removal of large acoustic neuroma could be acomplished via thetranslabyrinthine approach, with good result of facial nerve function and minimum incidence of morbidity.
