Surgical treatment of acoustic neuroma inside internal auditory canals [İnternal oditör kanal i̇çersindeki akustik nörinomlari{dotless}n cerrahi tedavisi]

Objective: this paper aims to investigate an approach to increase the total excision rate of tumor mass and the preservation rate of facial-acoustic nerve. methods: a total of consecutive 43 patients with acoustic neuroma were reviewed in this retrospective study. in all cases,the suboccipital retrosigmoid approach was used. preoperatively,patients accepted thin layer ct scanning through posterior cranial fossa and os petrosum. intraoperatively,the internal auditory canals (iac) of 31 patients were opened; and electrophysiologic monitoring on the cranial nerve viii was progressed. results: thirty-seven cases of tumors were totally removed (86.1%),and the rest 6 cases had subtotal resections. facial nerves were anatomically preserved in 41 cases (95.3%). four cases had a facial nerve function of house-brackmann (h-b) grade i,and 24 cases were h-b grade ii to iii,and 4 cases were grade iv. two in four patients having preoperative hearing retained hearing postoperatively. no postoperative death. conclusion: to be familiar with the pathologic anatomy relationship between cranial nerve vii and viii inside iac,to skillfully grasp the technique of microdrill,together with the application of intraoperative electrophysiological detection technology and microsurgical technique,are the key points for the preservation of cranial nerve vii and viii when resecting acoustic neuroma tumors intraoperatively.