Microsurgical resection of an acoustic neuroma via the translabyrinthine approach

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Author: Walter Jean
Published:
Specialties: Neurosurgery, Otolaryngology
Schools: Georgetown University Hospital
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Basic Info

Contributors: H. Jeffrey Kim

The translabyrinthine approach has often been reserved for large acoustic neuromas because it requires less retraction on the cerebellum when compared to the retrosigmoid approach for a similar tumor. However, the translabyrinthine approach is equally useful for smaller tumors, when the patients has no residual ipsilateral hearing. It allows for early visualization of the facial nerve, and thus better protection of this crucial nerve.

DOI #: http://dx.doi.org/10.17797/168b12z8m4

Advanced

Procedure

Translabyrinthine approach for resection of acoustic neuroma

Indications

Acoustic neuroma in patient with no residual ipsilateral hearing

Contraindications

small tumor with usable ipsilateral hearing

Instrumentation

Setup

Preoperative Workup

CT of temporal bone
MRI of brain

Anatomy and Landmarks

interal acoustic meatus
facial nerve
vestibulocochlear nerve
brainstem

Advantages/Disadvantages

Advantage: early visualization of facial nerve and better protection
Disadvantage: the approach eliminates any remaining hearing function on the ipsilateral side

Complications/Risks

injuries to venous sinues, facial nerve, brainstem
CSF leak

Disclosure of Conflicts

injuries to venous sinues, facial nerve, brainstem
CSF leak

Acknowledgements

References

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