SURGERY OF ACOUSTIC NEURINOMA

¹Selçuk Üniversitesi Tıp Fak., KBB AD, Konya, Türkiye
²Selçuk Üniversitesi Tıp Fak., Nöroşirürji AD, Konya, Türkiye Objectives: To present our approaches for acoustic tumor treatment and evaluate the results. Patients and Methods: Thirteen cases with acoustic tumor have been included in this study. All cases were evaluated with complete neuro-otologic examination. Audiometric tests (pure-tone audiogram, acoustic impedance, auditory brainstem response audiometry), magnetic resonance imaging (MRI) and/or CT scan, and caloric tests were also performed. Ten patients were treated surgically and the remainin three patients were followed by MRI to monitor tumor growth. Results: Eight of the cases were female and five of them were male. The average age was 40.3. 84.6% of the cases had unilateral hearing loss, 53.8% had tinnitus and 7.7% had sudden hearing loss as the presenting symptom. Caloric responses were decreased in the effected ears in %69.2 of the cases. Tumors larger than 40 mm could be resected subtotally (%20), the others were removed completely (80%). In one case, the facial nerve could not be saved and a re-innervation procedure was performed by end-to-and nerve anastomosis. Cerebrospinal fluid fistula developed in one case (10%). The patients, in whom tumor removal was incomplete, were followed up with MRI and none of them showed increase in the size of the tumor. The patients in whom total resection was achieved, no recurrence was detected in the mean follow-up period of 58.6 months (range: 10-119 months). The size of the tumor in MRI showed no increase in three cases who were not treated surgically, in the mean follow-up period of 21 months. Conclusion: One should revise each technique for the risks of leaving residual tumor and trauma to the facial nerve, when deciding for the most appriopriate approach in the surgical treatment of an acoustic neurinoma. In our experience, the translabyrinthine approach provides satisfactory results, in terms of total tumor removal and facial nerve preservation. Keywords : Acoustic neurinoma, treatment, surgery