Supine-lateral Approach versus Sitting Operation—Statistical Analysis of Brainstem, Cranial Nerve and Cerebellar Function in 165 Acoustic Neurinomas

Abstract

Among 165 cases of unilateral acoustic neurinomas operated on at the Department of Neurosurgery, University of Tokyo, 29 cases were treated in the sitting position and 18 cases by the supine-lateral approach both using a microscope. In spite of the difficulty of keeping the operative field clear, the supine-lateral approach has certain advantages. Not only the danger of air embolism is avoided, but also a wide field providing access to the brainstem can be facilitated without undue retraction of the cerebellar hemisphere.
Our operative results indicate that in the supine-lateral approach the period of postoperative hospitalization is shortened, that the facial nerve is better preserved and that postoperative residual neurological complaints, especially staggering gait are less frequent.