Middle fossa approach for hearing preservation with acoustic neuromas.

OBJECTIVE

This study aimed to provide a clinical review of middle fossa approach for hearing preservation in acoustic neuroma surgery.

STUDY

DESIGN

This was a prospective case review.

SETTING

The study was performed in a tertiary referral center of a private otologic practice.

PATIENTS: One hundred fifty-one consecutive middle fossa approaches for removal of acoustic neuroma were used. The 91 males and 60 females ranged in age from 10-72 years with a mean age of 48 years. Tumor size ranged from 0.5-2.5 cm, with a mean of 1.2 cm.

MAIN OUTCOME MEASURES: House-Brackmann facial nerve grade and hearing level classified both by the American Academy of Otolaryngology-Head and Neck Surgery criteria for reporting results of hearing preservation surgery and by comparison with preoperative level (15 dB/15%) were the main outcome measures.

RESULT: Measurable hearing was preservation in 68%, with 52% within 15 dB and 15% discrimination. Excellent facial function (House-Brackmann grade I-II) was obtained in 95% of patients.

CONCLUSION

The middle fossa craniotomy approach for acoustic neuroma is a reliable approach with a good hearing preservation rate and excellent facial nerve function outcome. Complications are minimal in this group of patients.