Acoustic neuromas: a review of 58 patients and correlation of tumour-size to the outcome.

Fifty eight patients with acoustic neuromas, who presented over a six year period were reviewed. These patients were sub divided into three groups according to their tumour size. Group A comprised of 21 patients with lesions less than 2 cm in diameter, of which 83% presented in the last two years. Group B comprised of 30 patients with lesions measuring 2-4 cm, of which 43% presented in the last two years. Group C included 7 patients with lesions greater than 4 cm in size, of which 14% presented in the corresponding period. The relative increase in the number of patients in Group A and decrease in Group C over the years is a direct reflection of heightened clinical awareness and increased usage of magnetic resonance imaging for diagnosis. Complete surgical excision was achieved in 20/21 patients in Group A and 4/7 patients in Group C, with an overall complete excision rate of 81%. The overall facial nerve preservation rate was 81% of which 20/21 patients were in Group A, 23/30 in Group B and 4/7 in Group C. The surgical morbidity ranged from 10% in Group A to 28% in Group C. There were no deaths in Group A compared to two each in Group B and Group C. This emphasises the importance of early detection and treatment of acoustic neuromas when they are small.