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Microsurgery of Acoustic Neuromas

There are several surgical approaches that may be used to remove an acoustic tumor. The type of approach is individualized depending on the patient’s wishes, hearing level, other neurological symptoms, and location and size of the tumor.

Middle Fossa Approach

In the middle fossa approach, the bone is opened above the ear and the bone overlying the tumor is removed. The inner ear is not entered. Therefore, hearing preservation is possible. The middle fossa approach is most suitable for small tumors in patients with good hearing.

Retrosigmoid Approach

In this approach, the bone is opened behind both the mastoid bone and the inner ear. In this way the tumor is removed from behind the inner ear. Retrosigmoid removal also allows the possibility of hearing preservation and may be used for both small and large tumors.

Translabyrinthine Approach

In the translabyrinthine approach, the mastoid bone behind the ear is removed and the inner ear is opened. This exposes the internal auditory canal directly. All hearing is lost with this approach. The translabyrinthine approach is, therefore, used only for those cases where hearing loss is already severe or the tumor is so large that hearing preservation is not a realistic goal.
The hospital stay after any type of microsurgery ranges from 4-7 days. Approximately 4-6 weeks is suggested for recovery.

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