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Hearing conservation in acoustic neuroma surgery via the posterior fossa

Published online by Cambridge University Press:  29 June 2007

D. L. Baldwin*
Affiliation:
The Department of Otolaryogology, The London Hospital, Whitechapel, LondonE1 1BB.
T. T. King
Affiliation:
The Department of Neurosurgery, The London Hospital, Whitechapel, LondonE1 1BB.
A. W. Morrisin
Affiliation:
The Department of Otolaryogology, The London Hospital, Whitechapel, LondonE1 1BB.
*
Mr. David L. Baldwin F.R.C.S., Department of Otolaryngology, St. Mary's Hospital, Praed Street, London W2.

Abstract

An increasing number of patients with an acoustic neuroma present with useful hearing in the tumour ear. Surgical removal of these tumours via the posterior fossa route may enable preservation of the cochlear nerve and otic capsule without increasing the morbidity to the facial nerve. The results of treating 51 cases of acoustic neuroma via the posterior fossa is presented. Forty four tumours measured less than 20 mm in diameter in the cerebellopontine angle and surgery was undertaken with hearing preservation as a principle objective. In 26 cases, the cochlear nerve was preserved anatomically and post-operative hearing at levels better than mean pure tone threshold of 50 dB or 50 per cent speech discrimination was recorded in 14 patients. The preservation of hearing represents a worthwhile surgical goal in selected patients with an acoustic neuroma without increasing the operative morbidity.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1990

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References

Coben, N. L., Berg, H., Hammerschlag, P., Ransohoff, J. (1986) Acoustic neuroma surgery: An eclectic approach with emphasis on preservation of hearing. Annals of Otology, Rhinology and Laryngology, 95: 2127.Google Scholar
Gasscock, M. E., McKennan, K. X., Levine, S. C. (1987a) Acoustic neuroma surgery: The results of hearing conservation surgery. Laryngoscope 97: 785790.CrossRefGoogle Scholar
Glasscock, M. E., Levine, S. C., McKennan, K. X. (1987b) The changing characteristics of acoustic neuroma patients over the last 10 years. Laryngoscope, 97: 11641167.CrossRefGoogle ScholarPubMed
Harder, H. (1988) Audiovestibular tests in the diagnosis of cerabellopontine angle tumours. Acta Otolaryngologica, Supplement 452: 511.CrossRefGoogle ScholarPubMed
Harker, J. A., McCabe, B. F. (1978) Iowa results of acoustic neuroma operations. Laryngoscope, 88: 1904–11.CrossRefGoogle ScholarPubMed
House, W. F. (1964) Transtemporal bone microsurgical removal of acoustic neuromas. Archives of Otolaryngology 80: 599–576.Google ScholarPubMed
House, W. F., Hitzelberger, W. E. (1968) Preservation of the facial nerve in acoustic tumour surgery. Archives of Otolaryngology 88: 655–8.CrossRefGoogle Scholar
House, W. F., Gardiner, G., Hughes, R. L. (1968) Middle cranial fossa approach to acoustic tumour surgery. Archives of Otolaryngology, 88: 631.CrossRefGoogle Scholar
Miller, J. M., Marks, N. J., Goodwin, P. C. (1983) Laser Doppler measurements of cochlear blood flow. Hearing Research, 11: 385394.CrossRefGoogle ScholarPubMed
Morrison, A. W., King, T. T. (1982) Translabyrinthine removal of acoustic neuromas. 227233, Neurological Surgery of the Ear and Skull Base. Ed. Brackmann, DE, Raven Press, New York.Google Scholar
Nadol, J. B., Levine, R., Martuza, R. L., Ojemann, R. G., Montgomery, W. W., Klevens de Sandoval, P. 1987 Preservation of hearing in surgical removal of acoustic neuromas of the internal auditory canal and cerebellar pontine angle. Laryngoscope, 97: 12871294.CrossRefGoogle ScholarPubMed
Palva, T., Troupp, H., Jauhiainen, T. (1985). Hearing preservation in acoustic neuroma surgery. Acta Otolaryngologica, 99: 17.Google Scholar
Silverstein, H., McDaniel, A., Norrell, H., Haberkamp, T. (1986) Hearing preservation after acoustic neuroma surgery with intraoperative direct eighth cranial nerve monitoring: Part I. A classification of results. Otolaryngology—Head and Neck Surgery, 95: 285291.CrossRefGoogle Scholar
Smith, M. F. W., Miller, R. N., Cox, D. J. (1973) Suboccipital microsurgical removal of acoustic neurinomas of all sizes. Annals of Otology, Rhinology and Laryngology, 82: 407414.CrossRefGoogle ScholarPubMed
Sterkers, J. M., Sterkers, O., Maudelonde, C., Corlieu, P. (1984) Preservation of hearing by the retrosigmoid approach in acoustic neuroma surgery. Advances in Oto-Rhino-Laryngology, 34: 187–92.CrossRefGoogle ScholarPubMed
Thomsen, J., Tos, M. (1988) Acoustic Neuromas. Diagnostic delay, growth rate and possible non-surgical treatment. Acta Otolaryngologica, Supplement. 452: 2633.Google Scholar
Tos, M., Thompsen, J., Harmsen, A. (1988a) Results of translabyrinthine removal of 300 acoustic neuromas related to tumour size. Acta Otolaryngologica Supplement 452: 3851.Google Scholar
Tos, M., Thomsen, J., Harmsen, A. (1988b) Is preservation of hearing in acoustic neuroma worthwhile? Acta Otolaryngologica Supplement, 452: 5768.Google Scholar