Abstract
The aim of this article is to illustrate several techniques for avoiding surgical complications in acoustic tumor surgery, as well as to report surgical results of 100 cases of acoustic tumors that have been operated on by the author (T.S.). Requisites for successful tumor removal are as follows : clear understanding of the three-dimensional relationship between the facial nerve, the vestibulocochlear nerve and the tumor, identification of the facial nerve using both electrical stimulation and visual inspection, continuous monitoring of the facial and cochlear nerve functions using evoked electromyogram and auditory brain stem response respectively, and finally, meticulous manipulation. Anatomic facial nerve preservation was achieved in 96 out of 100 cases (96%). Of these patients, 60% experienced normal or nearly normal (House-Brackmann grades 1 & 2) facial nerve function upon discharge. At a 6 month follow-up, the rate improved to 83%. Out of 19 patients with preoperative hearing of Gardner's class 1, 9 patients (47%) retained the same class 1 hearing, while 3 patients (16%) belonged to Gardner's class 2 after surgery, making the rate of useful hearing preservation of this group 63%. In another 12 patients with preoperative hearing of Gardner's class 2, 4 patients (33%) retained class 2 hearing after surgery. Of all the 31 patients with useful hearing before surgery, 52% (16/31) of the patients retained useful hearing (classes 1 & 2) after surgery.
