Optimal Approach to Tumours of the PostcerebellarAngle. Universal Path or Eclectic Philosophy in the Seletion of the Approach

Overview

A more varied selection of approaches to the inner auditory meatus and pontocere-bellar angle gives the patient a better chance of postoperative morbidity not only as regards earlypostoperative complications but also from the aspect of the function of the facial nerve andpreservation of hearing. The authors analyzed a group of 136 operated unilateral schwannomas,incl. 131 operated from a retrosigmoid approach, three from a translabyrinthine approach and twovia the middle cranial fossa. The middle cranial fossa approach is the most considerate surgicalmethod. It can be used only in small intracanalicular schwannomas, further selection dependingon ENG, BERA and NMR findings. The translabyrinthine and retrosigmoid approach is usuallyselected in an attempt to preserve acceptable hearing, the translabyrinthine approach could beused preferentially where hearing cannot be preserved. This procedure has as a rule smallerpostoperative complications than the retrosigmoid approach.v

Key words:
vestibular schwannoma, route of approach, extirpation.