Suboccipital Microsurgical Removal of Acoustic Neurinomas of All Sizes

Smith, Mansfield F. W.; Miller, Ray N.; Cox, Dale

doi:10.1177/000348947308200401

Cited by 26 publications

(4 citation statements)

References 5 publications

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“…The pioneers were Elliot and McKissock in 1954 1 who reported on two successful cases of tumor removal with suboccipital approach. Pertuiset 2 , Smith 3 , Bremond 4 and Sterkers 5 followed. In 1984 Jannetta 6 gave a detailed description of surgical and neuromonitoring technique and reported on the hitherto papers on hearing preservation surgery.…”

Section: Advancements and Open Issuesmentioning

confidence: 99%

Surgery of the lateral skull base: a 50-year endeavour

Zanoletti¹,

Mazzoni²,

Martini³

et al. 2019

Acta Otorhinolaryngol Ital

102

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SUMMARY Disregarding the widely used division of skull base into anterior and lateral, since the skull base should be conceived as a single anatomic structure, it was to our convenience to group all those approaches that run from the antero-lateral, pure lateral and postero-lateral side of the skull base as “Surgery of the lateral skull base”. “50 years of endeavour” points to the great effort which has been made over the last decades, when more and more difficult surgeries were performed by reducing morbidity. The principle of lateral skull base surgery, “remove skull base bone to approach the base itself and the adjacent sites of the endo-esocranium”, was then combined with function preservation and with tailoring surgery to the pathology. The concept that histology dictates the extent of resection, balancing the intrinsic morbidity of each approach was the object of the first section of the present report. The main surgical approaches were described in the second section and were conceived not as a step-by-step description of technique, but as the highlighthening of the surgical principles. The third section was centered on open issues related to the tumor and its treatment. The topic of vestibular schwannoma was investigated with the current debate on observation, hearing preservation surgery, hearing rehabilitation, radiotherapy and the recent efforts to detect biological markers able to predict tumor growth. Jugular foramen paragangliomas were treated in the frame of radical or partial surgery, radiotherapy, partial “tailored” surgery and observation. Surgery on meningioma was debated from the point of view of the neurosurgeon and of the otologist. Endolymphatic sac tumors and malignant tumors of the external auditory canal were also treated, as well as chordomas, chondrosarcomas and petrous bone cholesteatomas. Finally, the fourth section focused on free-choice topics which were assigned to aknowledged experts. The aim of this work was attempting to report the state of the art of the lateral skull base surgery after 50 years of hard work and, above all, to raise questions on those issues which still need an answer, as to allow progress in knowledge through sharing of various experiences. At the end of the reading, if more doubts remain rather than certainties, the aim of this work will probably be achieved.

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Section: Advancements and Open Issuesmentioning

confidence: 99%

Surgery of the lateral skull base: a 50-year endeavour

Zanoletti¹,

Mazzoni²,

Martini³

et al. 2019

Acta Otorhinolaryngol Ital

102

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“…Tos und Thomson (1982) stellten die Frage, ob es gerechtfertigt sei, den translabyrintharen Zugang zu verlassen, wenn die Chancen eines Hörerhalts als gering anzusetzen sind. In den Publikationen zwischen 1968 und 1980 finden sich Einzelfallbeschreibungen von Hörerhalt ohne Besserung der Hörfunktion nach Akustikusneurinom-und Meningeomoperationen (Smith, 1973;McCarty, 1975).…”

Section: Diskussionunclassified

Prä- und postoperative Hörschwellen und Hirnstammpotential bei Akustikusneurinomen*

Höhmann¹

1988

Laryngo-Rhino-Otol

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Akustikusneurinomen operiert. In 95 Fallen wurde em translabyrintharer mid in 41 Fallen em transtemporaler Zugang gewahit. Alle Patienten zeigten eine Innenohrbeteiligung bis zur Ertaubung. Kriterien zur Wahi des operativen Zuganges waren die Tumorgrölle, das Hórvermogen, das Alter und der Gesundheitszustand des Patienten. Tumoren unter 2 cm Durchmesser bei schlechtem zustand des Patienten. Tumoren unter 2 cm Durchmesser bej schlechtem Hbrvermögen wurden translabyrinthär operiert. Mit einem Hörverlust von im Mittel 50dB oder weniger, einem Diskriminationsverlust

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“…It is known from the reports by Rand and Kurze [6], Smith et al [8] as well as Rhoton [7] and Montgomery [3] that small, medium-sized and large tumors can equally well be removed from the suboccipital-transmeatal approach, with preservation of the facial nerve and, not infrequently, of hearing as well. It is common knowledge that there is no proportionate relationship between the size of the acoustic neurinomas and the symptoms produced by them; most importantly the degree of hearing loss [4], At operation, we have repeatedly diagnosed and confirmed medium sized tumors with residual hearing or with loss of hearing.…”

mentioning

confidence: 99%

Operated Bilateral Acoustic Neurinoma with Preservation of Hearing and Facial Nerve Function

Piffkó¹,

Pásztor²

1981

ORL

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After a brief survey of the microsurgical methods for acoustic neurinomas, a case is described in which a successful bilateral operation has been performed. Facial nerve function could be preserved on both sides and on the side of the still functioning ear hearing could also be saved. At 12 months following the operation pure tone and speech hearing were found to be the same as before the operation.

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Suboccipital Microsurgical Removal of Acoustic Neurinomas of All Sizes

Cited by 26 publications

References 5 publications

Surgery of the lateral skull base: a 50-year endeavour

Surgery of the lateral skull base: a 50-year endeavour

Prä- und postoperative Hörschwellen und Hirnstammpotential bei Akustikusneurinomen*

Operated Bilateral Acoustic Neurinoma with Preservation of Hearing and Facial Nerve Function

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