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ABSTRACT-Questionnaires retuned from 202 patients who had -undergone acoustic neuroma resection were analyzed with special reference to the effect on tinnitus of surgery that attempted to preserve hearing versus surgery that did not. We also examined the relationship between postoperative hearing and tinnitus following surgery to -preserve hearing (103 patients, HP group). Tinnitus, one of the most common symptoms of an acoustic neuroma. may be the initial symptom leading to its diagnosis. The literature indicates that tinnitus occurs in 60-80% of the patients preoperatively.1-6 However, few comprehensive studies have been carried out on its postoperative occurrence.24.6.7 Preoperative counseling of the patients also tends to ignore tinnitus as a possible side effect, concentrating primarily on the rates of mortality and serious morbidity. This apparent medical indifference can be explained in part by the impossibility of measuring this subjective complaint and the difficulty of describing and classifying it. Recent advances in diagnostic and surgical techniques have, however, drastically reduced the mortality and morbidity rates associated with tumor resection. Consequently, postoperative tinnitus has increased in importance as a factor affecting the patient's quality of life.We analyzed the effect of acoustic neuroma resection via the (extended) middle cranial fossa approach on postoperative tinnitus. The analyses were made with special reference to the effect on tinnitus of attempted hearing preservation versus nonhearing preservation surgery. In light of these results, we discuss the rationale for attempting to preserve hearing when surgically treating acoustic neuromas.

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The prognosis and the recovery process of facial nerve paralysis were reviewed in 74 patients who, despite preservation of nerve continuity, showed no facial movement after acoustic neuroma resection. In 50 or 67.6% of patients, facial movement recovered sufficiently so as not to require any reanimation procedures. However, no apparent sign of remission was observed for 7–49 months in the other 24 patients (32.4%), and hypoglossal-facial nerve anastomosis was performed in 20 of these patients. When remission was seen, the first sign of muscle movement appeared most frequently after 3–4 months but, in a small number of patients, it was also seen within 1.5 months or after 5–10 months. Based upon these results, the timing of reanimation procedures for facial nerve paralysis following acoustic neuroma resection is discussed.

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