A one‐stage combined approach for the management of large cerebellopontine angle tumors

Glasscock, Michael E.; Hays, James W.; Jackson, C. Gary; Steenerson, Ronald L.

doi:10.1288/00005537-197810000-00001

Cited by 52 publications

(18 citation statements)

References 7 publications

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“…For instance, some investigators reported that the rate was 92% or higher in patients with small or mediumsized tumors. Among patients with large tu mors, a facial nerve preservation rate of 20% was reported by King [8], 67% by Glasscock et al [2], and 77% by Tos and Thomson [11]. Our result (69%), shown in table V, can be said to be similar to the results in the abovementioned reports.…”

Section: Rate O F Facial Nerve Preservationsupporting

confidence: 89%

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Results of Surgery by the Modified Extended Middle Cranial Fossa Approach in 100 Patients with Acoustic Neuroma

Kanzaki¹,

Shiobara

Toya

1986

ORL

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The results of surgery by the middle cranial fossa (MCF) approach or the modified extended MCF approach in 100 patients with acoustic neuroma are reported. The rates of facial nerve preservation, tumor removal, and hearing preservation were reported and discussed. This surgical procedure can be applied to tumors of any size, from tumors confined to the internal auditory canal to those extending into the posterior fossa.

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Section: Rate O F Facial Nerve Preservationsupporting

confidence: 89%

“…If only the rate of total removal is considered, there are reports stating such fa vorable figures as 98% [2,11], while Palva and Troupp [10] reported a total removal rate of 72% by the TL method. Our finding of 81 % lies between the above percentages.…”

Section: Mortality and Tumor Removalmentioning

confidence: 99%

Results of Surgery by the Modified Extended Middle Cranial Fossa Approach in 100 Patients with Acoustic Neuroma

Kanzaki¹,

Shiobara

Toya

1986

ORL

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“…In a study in which the suboccipital approach was combined with the translabyrinthine approach, the anatom ical facial nerve preservation rate was found to be 84% [2], Large discrepancies are seen in the results obtained by different investiga tors on the functional preservation rate, es pecially in patients with large tumors, for whom rates of 14.5 [6], 77 [8], and 75-92% [10] have been reported. Although func tional preservation is more important than anatomical preservation, there are few de tailed reports on this subject.…”

Section: Discussionmentioning

confidence: 99%

Facial Nerve Function after Surgery for Removal of Acoustic Neuroma by the Extended Middle Cranial Fossa Approach

Kanzaki¹,

Shiobara

Toya

1986

ORL

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Postoperative facial nerve function was evaluated in 98 patients operated on by the middle cranial fossa approach or the extended middle cranial fossa approach from June 1976 to April 1985. In this series, the smaller the tumor size at the time of the initial surgery, the better the postoperative facial nerve function was. The facial nerve was preserved in 83.4% of the 79 patients who were subjected only to the initial surgery. However, total removal of the tumor along with facial nerve preservation was achieved only in 70.8%. Anatomical preservation of the facial nerve was possible in 78% of 87 patients. The postoperative functional results among patients in whom facial nerves were anatomically preserved were satisfactory (facial expression score of 75% or higher, i.e., 30 points or more out of a possible 40 points) in 70–80% of the patients with small size or intracanalicular tumors, but, in less than 50% of the patients with tumors of medium size or larger. There is a need to obtain higher rates of functional preservation as well as higher rates of satisfactory functional results. At the present stage, we must strive to achieve earlier diagnosis so that surgery can be performed while the tumor is still medium-sized or small.

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“…3B), ready for use at the time of closure. 3. A large C-shaped postauricular incision is made, the belly of the "C" being at least 6 cm posterior to the postauricular crease (Fig.…”

Section: Methodsmentioning

confidence: 99%

“…The reported incidence of CSF leaks with this technique is 4 to 18%. [1][2][3][4] In an effort to reduce the incidence of such leaks, House5 used the temporalis muscle to close the dural opening. Nevertheless, in his first series of cases there was still a frequent occurrence of postoperative CSF leak.…”

Section: Prevention Of Cerebrospinal Fluidmentioning

confidence: 99%

Prevention of Cerebrospinal Fluid Leaks and Transtemporal Surgery of Acoustic Tumors

Kumar¹,

Siedentop²

1992

Skull Base

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In neurosurgical practice, postoperative cerebrospinal fluid (CSF) METHODSThe technique we have used for exposure and removal of space-occupying lesions located in the cerebellopontine angle is the modified transotic approach described by Fisch and Mattox. 10 To solve the problem of CSF leaks and subgaleal collections of CSF, a few changes have been instituted. The technique is as follows.1. Prior to making the head incision, the anterolateral aspect of the upper thigh is prepared and draped and an adequate amount of fat harvested. At the same time, a 6 x 8 cm piece of fascia lata is also harvested. Particular care is taken not to make a hole in this graft. The edges of the defect created in the fascia lata is approximated as closely as possible and the skin incision closed in two layers. A suction drain is left under the skin flap.2. While the fat is being harvested from the thigh, blood is drawn by venepuncture to prepare the autologous fibrin glue. Seventy-two milliliters of the patient's blood is mixed with 8 ml of sterile 10% sodium citrate solution. Equal volumes of this mixture is poured into eight sterile tubes and centrifuged at 3200 rpm for 10 minutes. The supernatant plasma from each tube is then poured into 199

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A one‐stage combined approach for the management of large cerebellopontine angle tumors

Cited by 52 publications

References 7 publications

Results of Surgery by the Modified Extended Middle Cranial Fossa Approach in 100 Patients with Acoustic Neuroma

Results of Surgery by the Modified Extended Middle Cranial Fossa Approach in 100 Patients with Acoustic Neuroma

Facial Nerve Function after Surgery for Removal of Acoustic Neuroma by the Extended Middle Cranial Fossa Approach

Prevention of Cerebrospinal Fluid Leaks and Transtemporal Surgery of Acoustic Tumors

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