scholarly journals Anesthesia Dolorosa of Trigeminal Nerve, a Rare Complication of Acoustic Neuroma Surgery

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Foad Elahi ◽  
Kwo Wei David Ho
Keyword(s):  
Trigeminal Nerve ◽  
Acoustic Neuroma ◽  
Cerebellopontine Angle ◽  
Medical Literature ◽  
Rare Complication ◽  
Spontaneous Pain ◽  
Tumor Removal ◽  
Acoustic Neuromas ◽  
Acoustic Neuroma Surgery ◽  
Acoustic Tumor

Anesthesia dolorosa is an uncommon deafferentation pain that can occur after traumatic or surgical injury to the trigeminal nerve. This creates spontaneous pain signals without nociceptive stimuli. Compression of the trigeminal nerve due to acoustic neuromas or other structures near the cerebellopontine angle (CPA) can cause trigeminal neuralgia, but the occurrence of anesthesia dolorosa subsequent to acoustic tumor removal has not been described in the medical literature. We report two cases of acoustic neuroma surgery presented with anesthesia dolorosa along the trigeminal nerve distribution. The patients’ pain was managed with multidisciplinary approaches with moderate success.

scholarly journals Retromastoid-sub occipital: A novel approach to cerebello pontine angle in acoustic neuroma surgery-our experience in 21 cases

2011 ◽  
Vol 02 (01) ◽  
pp. 023-026 ◽  
Author(s):  
PK Naya ◽  
RVS Kumar
Keyword(s):  
Facial Nerve ◽  
Acoustic Neuroma ◽  
Cerebellopontine Angle ◽  
Microsurgical Technique ◽  
Presigmoid Approach ◽  
Precise Knowledge ◽  
Novel Approach ◽  
Acoustic Neuroma Surgery ◽  
Acoustic Tumor ◽  
Neurovascular Structures

ABSTRACT Background: Acoustic neuroma surgery poses significant challenges regarding definite management and preservation of hearing and the facial nerve are of great concern. Aim: To analyze the efficacy of the retromastoid approach in acoustic neuroma surgery. Materials and Methods: Tumors operated between January 2002 and December 2008, by the authors, using the retromastoid approach, were analyzed. Twenty-one patients who presented with acoustic tumor were considered for this study. Discussion: Precise knowledge of the neuroanatomy in the cerebellopontine angle is the key to success and microsurgical technique is the sole factor for good outcome. Conclusion: Retromastoid, in fact is the approach to the skull base with minimal or no damage to neurovascular structures, in contrast to the translabyrinthine or presigmoid approach.

Translabyrinthine Approach for Acoustic Neuroma

Neurosurgery ◽  
2004 ◽  
Vol 54 (2) ◽  
pp. 391-396 ◽  
Author(s):  
John Diaz Day ◽  
Douglas A. Chen ◽  
Moises Arriaga
Keyword(s):  
Surgical Treatment ◽  
Acoustic Neuroma ◽  
Cerebellopontine Angle ◽  
Hearing Preservation ◽  
Retrosigmoid Approach ◽  
The Past ◽  
Translabyrinthine Approach ◽  
Acoustic Neuromas

Abstract THE TRANSLABYRINTHINE APPROACH has been popularized during the past 30 years for the surgical treatment of acoustic neuromas. It serves as an alternative to the retrosigmoid approach in patients when hearing preservation is not a primary consideration. Patients with a tumor of any size may be treated by the translabyrinthine approach. The corridor of access to the cerebellopontine angle is shifted anteriorly in contrast to the retrosigmoid approach, resulting in minimized retraction of the cerebellum. Successful use of the approach relies on a number of technical nuances that are outlined in this article.

scholarly journals Impact of extent of internal acoustic meatus tumor removal using translabyrinthine approach for acoustic neuroma surgery

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0253338
Author(s):  
Kuan-Wei Chiang ◽  
Sanford P. C. Hsu ◽  
Tsui-Fen Yang ◽  
Mao-Che Wang
Keyword(s):  
Predictive Factors ◽  
Acoustic Neuroma ◽  
Tumor Size ◽  
Tumor Control ◽  
Tumor Removal ◽  
Translabyrinthine Approach ◽  
Internal Acoustic Meatus ◽  
Acoustic Neuroma Surgery ◽  
The Impact ◽  
Facial Function

Objectives Many studies have investigated the surgical outcome and predictive factors of acoustic neuroma using different approaches. The present study focused on large tumors due to the greater likelihood of internal acoustic meatus involvement and the greater application of surgical intervention than radiosurgery. There have been no previous reports on outcomes of internal acoustic meatus tumor removal. We investigated the impact of the extent of internal acoustic meatus tumor removal using a translabyrinthine approach for large acoustic neuroma surgery and predictive factors of tumor control. Methods This retrospective study reviewed 104 patients with large cerebellopontine angle tumor >3 cm treated by translabyrinthine approach microsurgery. Predictive factors of postoperative facial palsy, tumor control, and extent of internal acoustic meatus tumor removal were assessed. Results The mean tumor size was 38.95 ± 6.83 mm. Postoperative facial function showed 76.9% acceptable function (House–Brackmann grade 1 or 2) six months after surgery. The extent of internal acoustic meatus tumor removal was a statistically significant predictor factor of poor postoperative facial function. Younger age, larger tumor size needing radiosurgery, and more extensive removal of tumor were associated with better tumor control. Conclusion More extensive internal acoustic meatus tumor removal was associated with poor postoperative facial function and better tumor control.

Some Observations in a Case of Acoustic Neuroma

1978 ◽  
Vol 43 (4) ◽  
pp. 459-466 ◽  
Author(s):  
Shlomo Silman ◽  
Stanley A. Gelfand ◽  
Tong Chun
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Acoustic Neuroma ◽  
Recent Theory ◽  
Acoustic Neuromas ◽  
Apparent Relationship ◽  
Stapedius Reflex ◽  
The Subject ◽  
Acoustic Tumor ◽  
Insight Into

The subject was a 47-year-old male with a moderate asymmetrical sensorineural hearing loss that initially presented cochlear signs except for positive stapedius reflex results. Over the course of only five weeks, he developed the audiological constellation of retrocochlear involvement. The retrocochlear results were confirmed by the removal of an acoustic tumor. The results highlight the importance of audiological monitoring and reflex measures in the identification of acoustic neuromas. Several observations provide insight into the apparent relationship between loudness and the stapedius reflex. The findings are discussed with reference to a proposed extension of Borg’s recent theory that elevated reflex thresholds and reflex decay reflect differing degrees of the eighth nerve destruction.

Asymmetry of the Internal Auditory Canals without Acoustic Neuroma

1978 ◽  
Vol 87 (6) ◽  
pp. 815-820 ◽  
Author(s):  
Kenneth D. Dolan ◽  
Richard W. Babin ◽  
Charles G. Jacoby
Keyword(s):  
Posterior Fossa ◽  
Acoustic Neuroma ◽  
Cerebellopontine Angle ◽  
Clinical Presentation ◽  
Internal Auditory Canal ◽  
Internal Auditory Meatus ◽  
Radiographic Appearance ◽  
The Past ◽  
Acoustic Neuromas ◽  
Normal Architecture

During the past five years, nine patients with “significant” unilateral enlargement of one internal auditory canal by polytomography were subsequently found to have freely filling canals on contrast posterior fossa myelography. The radiographic appearance of the enlarged canals varied greatly and included all the various configurations usually suggestive of acoustic neuroma. Likewise, the clinical presentation varied greatly from asymptomatic to highly suggestive of cerebellopontine angle tumor. This series underscores the essential nature of posterior fossa studies in the evaluation of potential acoustic neuromas and the variability of the normal architecture of the internal auditory meatus.

CT Cisternography of Paradoxical Cerebrospinal Fluid Rhinorrhea after Operation for Acoustic Neuroma

2005 ◽  
Vol 18 (5-6) ◽  
pp. 555-558 ◽  
Author(s):  
B. Thomas ◽  
S. Purkayastha ◽  
S. Vattoth ◽  
A.K. Gupta
Keyword(s):  
Cerebrospinal Fluid ◽  
Acoustic Neuroma ◽  
Cerebellopontine Angle ◽  
Csf Leak ◽  
Ct Cisternography ◽  
Csf Rhinorrhea ◽  
Cerebrospinal Fluid Rhinorrhea ◽  
Acoustic Neuroma Surgery ◽  
Air Cells ◽  
Mastoid Air Cells

Cerebrospinal fluid (CSF) rhinorrhea after acoustic neuroma surgery is a well-known complication. CT cisternography can be used to demonstrate the entry of CSF from cerebellopontine angle cistern into the mastoid air cells, middle ear and then into nasopharynx via Eustachian tube. We report a case of paradoxical CSF rhinorrhea after surgery for acoustic neuroma in which the path of CSF leak was accurately demonstrated using CT cisternography.

scholarly journals Impact of Balance Training and Co-ordination Exercises in Post-Operative Left Cerebellopontine Angle Tumor: A Case Report

2021 ◽  
pp. 413-416
Author(s):  
Aditi Akhuj ◽  
Snehal Samal ◽  
Rakesh Krishna Kovela ◽  
Ragini Dagal ◽  
Rebecca Thimoty
Keyword(s):  
Case Report ◽  
Acoustic Neuroma ◽  
Cerebellopontine Angle ◽  
Balance Training ◽  
Case Presentation ◽  
Cerebellopontine Angle Tumor ◽  
Acoustic Neuromas ◽  
Tumor Management ◽  
Mild Impairment

Introduction: Acoustic neuromas are most common tumors of CP angle, accounting more than 90% of all such tumors. Meningioma, primary cholesteratoma and facial nerve schwanoma are the different type of tumors. Acoustic neuroma is a benign tumor situates in CP angle which has a fibrous growth and originates from the division of vestibulochochlear nerve. Aim: Impact of Balance Training and Co-ordination Exercises in Post-Operative Left Cerebellopontine Angle Tumor Case Presentation: A 40 year old male with right hand dominance was referred to physiotherapy department. On examination he presented mild impairment in balance and co-ordination, assisted walking. Discussion: This case report is an important to the published literature on rehabilitation of a patient witha CPA tumor, as it presents the sequential management in the patients post CPA tumor. Conclusion: Acoustic neuroma is most common CPA tumor. Management of CPA tumor is important to improve quality of life. As per the reference articles and the exercises planned can progressively improve balance and co-ordination of patients.

scholarly journals Retrosigmoid Transmeatal Approach for Resection of Acoustic Neuroma: Operative Video and Technical Nuances of Subperineural Dissection for Facial Nerve Preservation

2019 ◽  
Vol 80 (S 03) ◽  
pp. S269-S270
Author(s):  
James K. Liu ◽  
Vincent N. Dodson ◽  
Robert W. Jyung
Keyword(s):  
Facial Nerve ◽  
Acoustic Neuroma ◽  
Protective Layer ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Tumor Removal ◽  
Nerve Preservation ◽  
Tumor Capsule ◽  
Acoustic Neuromas ◽  
Dissection Technique

The retrosigmoid (suboccipital) approach is the workhorse for most acoustic neuromas in the cerebellopontine angle. In this operative video atlas manuscript, the authors demonstrate the nuances of the subperineural dissection technique for microsurgical resection of an acoustic neuroma via the retrosigmoid transmeatal approach. The plane is developed by separating the perineurium of the vestibular nerve away from the tumor capsule. This perineurium provides a protective layer between the tumor capsule and the facial nerve which serves as a buffer to avoid direct dissection and potential trauma to the facial nerve. Using this technique during extracapsular tumor dissection helps to maximize the extent of tumor removal while preserving facial nerve function. A gross total resection of the tumor was achieved, and the patient exhibited normal facial nerve function (Fig. 1). In summary, the retrosigmoid transmeatal approach with the use of subperineural dissection are important strategies in the armamentarium for surgical management of acoustic neuromas with the goal of maximizing tumor removal and preserving facial nerve function (Fig. 2).The link to the video can be found at: https://youtu.be/L3lPtSvJt60.

Nuances in Acoustic Neuroma Surgery

Neurosurgery ◽  
2001 ◽  
Vol 49 (2) ◽  
pp. 337-341 ◽  
Author(s):  
Leonard I. Malis
Keyword(s):  
Learning Curve ◽  
Acoustic Neuroma ◽  
Steep Learning Curve ◽  
Microsurgical Technique ◽  
Surgical Microscope ◽  
Acoustic Neuromas ◽  
Surgical Methods ◽  
Acoustic Neuroma Surgery ◽  
The 1960S ◽  
New Generation

Abstract THIS ARTICLE DESCRIBES surgical methods developed during my resection of 600 acoustic neuromas, 599 of which were total removals. This series began in 1965, with the introduction of the surgical microscope and the development of microsurgical technique. In the 1960s, there was no established technology for the microsurgery of acoustic neuromas. Much of the work of the great early neurosurgeons—Cushing, Dandy, Olivecrona, and other remarkable pioneers—did not really apply. New approaches, solutions, and tools were introduced at that time, and there was a long, steep learning curve. I hope that some of the discussion herein makes learning easier for the new generation of neurosurgeons as they develop their own operative nuances.

Pain after Surgery for Acoustic Neuroma

1992 ◽  
Vol 107 (3) ◽  
pp. 424-429 ◽  
Author(s):  
David A. Schessel ◽  
Julian M. Nedzelski ◽  
David Rowed ◽  
Joseph G. Feghali
Keyword(s):  
Postoperative Pain ◽  
Surgical Technique ◽  
Acoustic Neuroma ◽  
Tumor Size ◽  
Cerebellopontine Angle ◽  
Significant Morbidity ◽  
Tumor Excision ◽  
Acoustic Neuromas ◽  
Age And Sex ◽  
Suboccipital Approach

Postoperative pain after surgery in the cerebellopontine angle (CPA) is acknowledged to occur, but is rarely taken into account as a factor in the analysis of morbidity of such surgery. It is widely acknowledged that some patients, having undergone such surgery, particularly by means of the suboccipital approach, report significant postoperative pain and headache. This study was undertaken to determine the incidence and severity of pain after excision of acoustic neuromas and to establish whether this differed between the suboccipital and translabyrinthine routes. Ninety-one percent of all patients (n = 58), who had the suboccipital approach used for removal of their tumor, were surveyed. A smaller group (n = 40), MAtched for tumor size, age, and sex, but in whom the translabyrinthine approach was used, was similarly studied. A standard questionnaire, designed to detect and quantify postoperative pain, was administered to each patient. Of patients who underwent tumor excision by means of the suboccipital approach, 63.7% experienced significant local discomfort and headache, whereas this was notably absent in all those who had undergone translabyrinthine excision. In view of the significant morbidity noted to follow the suboccipital approach, several modifications of the surgical technique used were devised.

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