Preservation of hearing in surgery for acoustic neuromas

1993 ◽  
Vol 78 (6) ◽  
pp. 864-870 ◽  
Author(s):  
Michael E. Glasscock ◽  
James W. Hays ◽  
Lloyd B. Minor ◽  
David S. Haynes ◽  
Vincent N. Carrasco
Keyword(s):  
Hearing Preservation ◽  
Middle Cranial Fossa ◽  
Senior Author ◽  
Speech Discrimination ◽  
Content Type ◽  
Auditory Evoked Response ◽  
Surgical Access ◽  
Acoustic Neuromas ◽  
Cranial Fossa ◽  
Fine Print

✓Preservation of hearing was attempted in 161 cases of histologically confirmed acoustic neuroma removed by the senior author between January 1, 1970, and September 30, 1991. There were 136 patients with unilateral tumors: 22 patients had bilateral tumors (neurofibromatosis 2) and underwent a total of 25 procedures. Hearing was initially preserved in 35% of patients with unilateral tumors and in 44% of those with bilateral tumors. Results are reported in terms of pre- and postoperative pure tone average and speech discrimination scores. Surgical access to the tumor was obtained via middle cranial fossa and suboccipital approaches. The latter has been used more often over the past 5 years because of a lower associated incidence of transient facial paresis. Persistent postoperative headaches have been the most common complication following the suboccipital approach. The results of preoperative brain-stem auditory evoked response (BAER) studies were useful in predicting the outcome of hearing preservation attempts. Patients with intact BAER waveform morphology and normal or delayed latencies had a higher probability of hearing preservation in comparison to those with abnormal preoperative BAER morphology.

Preservation of hearing in patients undergoing excision of acoustic neuromas and other cerebellopontine angle tumors

1985 ◽  
Vol 63 (2) ◽  
pp. 168-174 ◽  
Author(s):  
Charles H. Tator ◽  
Julian M. Nedzelski
Keyword(s):  
Tumor Size ◽  
Cerebellopontine Angle ◽  
Internal Auditory Canal ◽  
Hearing Preservation ◽  
Cochlear Nerve ◽  
Consecutive Series ◽  
Speech Discrimination ◽  
Content Type ◽  
Acoustic Neuromas ◽  
Fine Print

✓ Microsurgical techniques have made it possible to identify and preserve the cochlear nerve from its origin at the brain stem and along its course through the internal auditory canal in patients undergoing removal of small or medium-sized acoustic neuromas or other cerebellopontine angle (CPA) tumors. In a consecutive series of 100 patients with such tumors operated on between 1975 and 1981, an attempt was made to preserve the cochlear nerve in 23. The decision to attempt to preserve hearing was based on tumor size and the degree of associated hearing loss. In cases of unilateral acoustic neuroma, the criteria for attempted preservation of hearing were tumor size (2.5 cm or less), speech reception threshold (50 dB or less), and speech discrimination score (60% or greater). In patients with bilateral acoustic neuromas or tumors of other types, the size and hearing criteria were significantly broadened. All patients were operated on through a suboccipital approach. Hearing was preserved postoperatively in six (31.6%) of the 19 patients with unilateral acoustic neuromas, although the cochlear nerve was preserved in 16. Of the six patients with postoperative hearing, three retained excellent hearing, and the other three had only sound awareness and poor discrimination. Hearing was preserved in three cases with other CPA tumors, including an epidermoid cyst and small petrous meningiomas in the internal auditory canal. Of the two cases with bilateral tumors, hearing was preserved in one. Of the 23 patients in whom hearing preservation was attempted, nine (39.1%) had some postoperative hearing, which in six was equal to or better than the preoperative level. Thus, it is worthwhile to attempt hearing preservation in selected patients with CPA tumors.

Hearing preservation in acoustic neuroma surgery: importance of adhesion between the cochlear nerve and the tumor

2002 ◽  
Vol 97 (2) ◽  
pp. 337-340 ◽  
Author(s):  
Takuzou Moriyama ◽  
Takanori Fukushima ◽  
Katsuyuki Asaoka ◽  
Pierre-Hugues Roche ◽  
David M. Barrs ◽  
...  
Keyword(s):  
Acoustic Neuroma ◽  
Hearing Preservation ◽  
Cochlear Nerve ◽  
Significant Prognostic Factor ◽  
Speech Discrimination ◽  
Middle Fossa ◽  
Content Type ◽  
Middle Fossa Approach ◽  
Acoustic Neuromas ◽  
Fine Print

Object. To evaluate the possible prognostic factors for hearing preservation, the authors retrospectively reviewed the results of 30 consecutive acoustic neuroma operations in which hearing preservation was attempted, in a total series of 63 acoustic neuromas. Methods. Intracanalicular tumors or those that extended less than 3 mm outside the porus acusticus (10 cases) were resected via the middle fossa approach. The retrosigmoid approach was used for tumors exceeding the limits for the middle fossa approach (20 cases). Overall, hearing was preserved (pure tone average ≤ 50 dB and speech discrimination score ≥ 50%) in 21 patients (70%). There were 11 patients with severe adhesion between the cochlear nerve and tumor capsule, and 19 without. Hearing was preserved postoperatively in only two (18.2%) of 11 patients with severe adhesion, whereas all 19 without severe adhesion had hearing preservation. Conclusions. The presence or absence of severe adhesion in the interface between the cochlear nerve and the tumor might be the most significant prognostic factor for hearing preservation postsurgery.

Angiofibroma of the middle cranial fossa

1971 ◽  
Vol 35 (1) ◽  
pp. 90-94 ◽  
Author(s):  
G. Vasudeva Iyer ◽  
N. D. Vaishya ◽  
A. Bhaktaviziam ◽  
G. M. Taori ◽  
Jacob Abraham
Keyword(s):  
Young Woman ◽  
Middle Cranial Fossa ◽  
Intracranial Tumor ◽  
Rare Occurrence ◽  
Content Type ◽  
Cranial Fossa ◽  
Primary Intracranial Tumor ◽  
Fine Print

✓ The rare occurrence of angiofibroma as a primary intracranial tumor in the middle cranial fossa is reported in a young woman, and related reports are reviewed.

Superior semicircular canal dehiscence syndrome

2004 ◽  
Vol 100 (1) ◽  
pp. 123-124 ◽  
Author(s):  
Mitchell J. Ramsey ◽  
Michael J. McKenna ◽  
Fred G. Barker
Keyword(s):  
Semicircular Canal ◽  
Chronic Otitis Media ◽  
Middle Cranial Fossa ◽  
Content Type ◽  
Superior Semicircular Canal Dehiscence ◽  
Superior Semicircular Canal ◽  
Cranial Fossa ◽  
Vestibular Symptoms ◽  
Fine Print ◽  
Canal Dehiscence

✓ The authors present the case of a man who had superior semicircular canal dehiscence syndrome in addition to chronic otitis media. This case is atypical because the patient coincidentally had middle ear and mastoid disease, which previously had been treated surgically. The prior ear surgery delayed the diagnosis of superior semicircular canal dehiscence syndrome and increased the complexity of the repair of the superior semicircular canal dehiscence. Superior semicircular canal dehiscence syndrome is a recently recognized syndrome resulting in acute or chronic vestibular symptoms. The diagnosis is made using history, vestibular examination, and computerized tomography studies. Neurosurgeons should be aware that patients with superior semicircular canal dehiscence syndrome who experience disabling chronic or acute vestibular symptoms can be treated using a joint neurosurgical—otological procedure through the middle cranial fossa.

Dural involvement in sinus histiocytosis with massive lymphadenopathy

1984 ◽  
Vol 60 (4) ◽  
pp. 850-852 ◽  
Author(s):  
Michel Trudel
Keyword(s):  
Unusual Case ◽  
Middle Cranial Fossa ◽  
Sinus Histiocytosis ◽  
Content Type ◽  
Massive Lymphadenopathy ◽  
Cranial Fossa ◽  
Left Middle ◽  
Fine Print

✓ An unusual case of an isolated histioproliferative lesion arising from the basal dura of the left middle cranial fossa is described. The presence of lymphophagocytosis suggests that this represents an extra-nodal, intracranial form of sinus histiocytosis with massive lymphadenopathy.

scholarly journals Middle cranial fossa approach for acoustic neuroma

2021 ◽  
Vol 5 (2) ◽  
pp. V12
Author(s):  
Paul W. Gidley ◽  
Joel Z. Passer ◽  
Joshua C. Page ◽  
Franco DeMonte
Keyword(s):  
Acoustic Neuroma ◽  
Hearing Preservation ◽  
Middle Cranial Fossa ◽  
Middle Fossa ◽  
Surgical Indications ◽  
Total Resection ◽  
Technical Aspects ◽  
Middle Fossa Approach ◽  
Acoustic Neuromas ◽  
Cranial Fossa

The middle fossa approach for the resection of small acoustic neuromas is a viable, but underutilized treatment modality with the goal of hearing preservation. The authors aim to demonstrate this approach and its nuances through this video presentation. A 38-year-old man presented with an incidentally discovered small, intracanalicular acoustic neuroma that was initially observed, but growth was noted. The patient had good hearing, and therefore a hearing preservation approach was offered. A gross-total resection was achieved, and the patient maintained good hearing postoperatively. This video demonstrates relevant anatomy, surgical indications, technical aspects of resection, including reconstruction, and postoperative outcomes. The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID21124

Osteoma of the middle cranial fossa

1972 ◽  
Vol 37 (5) ◽  
pp. 610-612 ◽  
Author(s):  
Y. S. Bhandari ◽  
R. A. C. Jones
Keyword(s):  
Epileptic Seizure ◽  
Middle Cranial Fossa ◽  
Content Type ◽  
Cranial Fossa ◽  
Fine Print

✓ The removal of an unusually large osteoma projecting into the middle cranial fossa is reported. The presenting symptom was a solitary generalized epileptic seizure.

Giant-cell tumor of the middle cranial fossa

1987 ◽  
Vol 66 (6) ◽  
pp. 924-928 ◽  
Author(s):  
J. Max Findlay ◽  
David Chiasson ◽  
Alan R. Hudson ◽  
Mario Chui
Keyword(s):  
Giant Cell Tumor ◽  
Giant Cell ◽  
Adjuvant Radiotherapy ◽  
Middle Cranial Fossa ◽  
Cell Tumor ◽  
Content Type ◽  
Cranial Fossa ◽  
The Right ◽  
Fine Print

✓ The authors report the case of a 23-year-old man with a giant-cell tumor of the right middle cranial fossa floor. His presentation and management are described, and some aspects of this rare neoplasm of the skull base are reviewed. The role of adjuvant radiotherapy is discussed.

Intracranial and extracranial neurogenic hamartoma

1977 ◽  
Vol 46 (4) ◽  
pp. 517-523 ◽  
Author(s):  
Anthony E. Gallo ◽  
James D. Smith
Keyword(s):  
Biological Activity ◽  
Head And Neck ◽  
Middle Cranial Fossa ◽  
Vascular Supply ◽  
Cervical Region ◽  
Content Type ◽  
Feeding Assessment ◽  
Cranial Fossa ◽  
Gelfoam Embolization ◽  
Fine Print

✓ A case of neurogenic hamartoma involving the middle cranial fossa, nasopharynx, and left anterior cervical region and presenting at birth as an obstructive oropharyngeal mass is described. Special management included Gelfoam embolization of the vascular supply, control of airway and feeding, assessment of biological activity of the mass, and appropriate staging of the procedure with neurosurgical, head and neck surgical, and radiological support.

Middle cranial fossa arachnoid cyst developing in infancy

1995 ◽  
Vol 82 (6) ◽  
pp. 1075-1077 ◽  
Author(s):  
Yoshinari Okumura ◽  
Toshisuke Sakaki ◽  
Hidehiro Hirabayashi
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Computerized Tomography ◽  
Arachnoid Cyst ◽  
Middle Cranial Fossa ◽  
Resonance Imaging ◽  
Content Type ◽  
New Findings ◽  
Cranial Fossa ◽  
Fine Print

✓ The pathophysiology of primary arachnoid cysts of the middle cranial fossa is still unclear, and no widely accepted therapeutic criteria for this condition have been established. The authors present the case of a 7-year-old boy with this cyst accompanied by temporal lobe hypoplasia. On the basis of computerized tomography taken on the 2nd day after birth and magnetic resonance imaging upon admission, the arachnoid cyst in this case was attributed to brain hypoplasia secondary to abnormal arachnoid development and was confirmed to have developed primarily during infancy. Experience with this case yielded new findings useful in clarifying the pathophysiology of this condition and establishing therapeutic criteria for such a case.

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