A modified retrosigmoid approach for direct exposure of the fundus of the internal auditory canal for hearing preservation in acoustic neuroma surgery.

摘要: Objective: This is a clinical report on modified retrosigmoid approach with direct exposure of the fundus internal auditory canal for hearing preservation in acoustic neuroma surgery. Study Design: Retrospective case review. Setting: Tertiary referral center an ear, nose, and throat department public hospital. Patients: One hundred fifty consecutive procedures were reviewed, including 61 males 89 females age range 13 to 69 years mean 47 years. There 15 patients tumor occupying solely 135 extension into cerebellopontine angle extrameatal diameter up 52 mm 11.5 mm. Intervention: The included wide craniotomy, perimeatal petrous bone removal blue line labyrinth, at orifices facial cochlear nerves. quadrant superior vestibular nerve remained unexposed. Main Outcome Measures: Hearing was measured according American Academy Otolaryngology-Head Neck Surgery criteria reporting results by comparison preoperative level. Facial function using House-Brackmann grading. radicality investigated mid- long-term magnetic resonance imaging (MRI). Results: Measurable preserved 45.3%, 32.4% these cases, it within dB/15% discrimination. Grade I or 2 85.3%. MRI follow-up revealed 3.3% residual regrowth complete series. No found 3-year last series operated control fundus. Conclusions: permits quadrants allows dissection under visual control. Removing from done blindly minority cases carries minimal risk tumor. technique requires only conventional equipment skills neurotology.