[Removal of large acoustic neuroma via suboccipito-retrosigmoid approach with microsurgical technique].

OBJECTIVE

To probe the treatment effects of large acoustic neuroma (LAN) via a suboccipito-retrosigmoid microsurgical operation.

METHODS

216 patients with LAN in the cerebellar pons angle were confirmed by CT or MRI in our department. Each tumor (diameter > or = 31 mm) was removed via a suboccipito-retrosigmoid microsurgical approach. Treatment results were evaluated and the preoperative and postoperative function of the acoustic nerve or the facial nerve was compared separately.

RESULTS

The tumors were totally removed in 172 patients(79.6%), subtotally removed in 33 (15.3%), and partially removed in 11 (5.1%). Anatomic preservation of the acoustic nerve was achieved in 27 patients (12.5%), and functional preservation in 9 patients (Grade A, 4.2%) at discharge. Anatomic preservation of the facial nerve was achieved in 178 patients (82.4%) and functional preservation in 94 (House Grade, Grade I - II, 52.8%) at discharge. Follow-up observation (Median: 3.9 years) of 187 patients revealed good recovery in 128 patients (68.4%), fair recovery in 44 (23.5%), and poor recovery in 15 (8.0%). Late recurrence was noted in those with poor recovery (10 patients, 5.4%) (cured by second treatment).

CONCLUSIONS

It is a safe and effective way to remove LAN via suboccipito-retrosigmoid approach with microsurgical technique.