Intentional Partial Removal of Large Acoustic Neuromas at the Era of Radiosurgery by Suboccipital Retrosigmoid Approach : Surgical Technique(SURGICAL TECHNIQUES and PERIOPERATIVE MANAGEMENT)

Abstract

The treatment goal of acoustic neuromas in the era of radiosurgery is preserving not only facial nerve function but also hearing function. Gamma knife radiosurgery is a useful treatment for small to medium size tumors below 3 cm in diameter. In large tumors above 3 cm in diameter, we attempted intentional partial tumor resection preserving cranial nerve functions and performing boost radiosurgery. We have described the surgical techniques of position, craniotomy, and the pitfalls involved in tumor resection for intentional partial resection of acoustic neuromas by the suboccipital retrosigmoid approach, based on our experience with 43 patients.