Results of Translabyrinthine Removal of 300 Acoustic Neuromas Related to Tumour Size

Abstract

The results from the Danish model of acoustic neuroma surgery are presented. In the period from 1976 to 1985, 300 patients with acoustic neuromas were operated upon using the translabyrinthine procedure. There were one small intrameatal tumour; 96 medium-sized tumours with an extrameatal diameter up to 25 mm; 85 large tumours, measuring 26–40 mm, and 118 very large tumours with a diameter exceeding 40 mm. The mortality rate was 2%, and CSF leak occurred in 11%, persisting for more than 2 weeks in 5% of the patients in whom the fistula had to be closed operatively. Facial nerve function was completely normal in 66%, slightly reduced in 17%, moderately reduced in 8% and abolished in 9%. The facial nerve was anatomically preserved in 95% of the patients. Reconstruction of the facial nerve, most often an XII-VII anastomosis, was performed in only 6% of the patients. Cerebellar symptoms, occurring in 45% preoperatively, were demonstrated in only 7% postoperatively. We find that a standardization of the measurement of tumor size and of the assessment of sequelae changes is urgently needed.