Preservation and Reconstruction of the Facial Nerve after Translabyrinthine Removal of 200 Acoustic Neuromas

2015 ◽  
pp. 176-186 ◽  
Author(s):  
Mirko Tos ◽  
Jens Thomsen
Keyword(s):  
Facial Nerve ◽  
Acoustic Neuromas

Staged Resection of Large Acoustic Neuromas: Indications, Surgical Results, Facial Nerve Outcomes, and Complications

Skull Base ◽  
2007 ◽  
Vol 17 (S 2) ◽  
Author(s):  
James Liu ◽  
Ilman Kim ◽  
Matthew Hunt ◽  
Sean McMenomey ◽  
Johnny Delashaw, Jr.
Keyword(s):  
Facial Nerve ◽  
Surgical Results ◽  
Acoustic Neuromas

Pre- and Postoperative Facial Nerve Testing in Patients with Acoustic Neuromas

1985 ◽  
Vol 99 (3-4) ◽  
pp. 239-244 ◽  
Author(s):  
Jens Thomsen ◽  
Poul Zander Olsen ◽  
Mirko Tos
Keyword(s):  
Facial Nerve ◽  
Acoustic Neuromas

scholarly journals How I Do It: The Role of Flexible Hand-held 2μ-Thulium Laser Fiber in Microsurgical Removal of Acoustic Neuromas

2017 ◽  
Vol 78 (04) ◽  
pp. 301-307 ◽  
Author(s):  
Guglielmo Cacciotti ◽  
Raffaele Roperto ◽  
Maria Tonelli ◽  
Ettore Carpineta ◽  
Luciano Mastronardi
Keyword(s):  
Facial Nerve ◽  
Tumor Resection ◽  
Hearing Preservation ◽  
Matched Pair ◽  
Nerve Preservation ◽  
Acoustic Neuromas ◽  
Laser Fiber ◽  
Laser Focusing ◽  
Preservation Rate

Aims We performed a retrospective nonrandomized study to analyze the results of microsurgery of acoustic neuromas (AN) using 2μ-thulium flexible hand-held laser fiber (Revolix jr). Methods From September 2010 to September 2015, 89 patients suffering from AN have been operated on with microsurgical technique via retrosigmoid approach. In 37 cases, tumor resection was performed with the assistance of 2μ-thulium flexible hand-held laser fiber (L-group). Eight cases operated on with the assistance of CO2 hand-held flexible laser fiber were excluded from this study. A total of 44 patients, operated on without laser assistance during the same period, were used as comparison group (C-group) (matched pair technique). Facial nerve function was assessed with the House–Brackmann (HB) scale preoperatively, and 1 week and 6 months postoperatively. Results Overall time from incision to skin suture changed in relation to size of tumor (165–575 minutes) and was not affected by the use of laser. In 7 out of 81 cases, a preoperative facial nerve palsy HB2 and in 1 case, HB4 (permanent) were observed. In the remaining 80 cases, at 6-month follow-up, facial nerve preservation rate (HB1) was 92.5%. Hearing preservation rate (AAO-HNS A/B classes) was 68.2% (26 out of 36). Adopting a 0 to 3 scale, the mean surgeon satisfaction rate of usefulness of laser fiber was 2.7. Conclusion The use of 2μ-thulium hand-held flexible laser fiber in AN microsurgery seems to be safe and subjectively facilitates tumor resection especially in “difficult” conditions (e.g., highly vascularized and hard tumors). In this limited retrospective trial, the good functional outcome following conventional microsurgery had not further improved, nor the surgical time reduced by laser. Focusing its use on “difficult” (large and vascularized) cases may lead to different results in future.

The Incidence of Facial Nerve Weakness Following Gamma Knife Radiosurgery for Acoustic Neuromas in Patients Over 60 Years Old

2002 ◽  
Vol 23 (Sup 1) ◽  
pp. S42-S43
Author(s):  
A Quinones-Hinojosa ◽  
N Sanai ◽  
P K. Sneed ◽  
D A. Larson ◽  
W M. Wara ◽  
...  
Keyword(s):  
Facial Nerve ◽  
Gamma Knife ◽  
Gamma Knife Radiosurgery ◽  
Acoustic Neuromas

Conservative versus Primary Surgical Treatment of Acoustic Neuromas: A Comparison of Rates of Facial Nerve and Hearing Preservation

Skull Base ◽  
2008 ◽  
Vol 18 (S 01) ◽  
Author(s):  
Thomas Martin ◽  
Konstance Tzifa ◽  
Caroline Kowalski ◽  
Roger Holder ◽  
Richard Walsh ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Facial Nerve ◽  
Hearing Preservation ◽  
Acoustic Neuromas

scholarly journals Retrosigmoid Transmeatal Approach for Resection of Acoustic Neuroma: Operative Video and Technical Nuances of Subperineural Dissection for Facial Nerve Preservation

2019 ◽  
Vol 80 (S 03) ◽  
pp. S269-S270
Author(s):  
James K. Liu ◽  
Vincent N. Dodson ◽  
Robert W. Jyung
Keyword(s):  
Facial Nerve ◽  
Acoustic Neuroma ◽  
Protective Layer ◽  
Nerve Function ◽  
Facial Nerve Function ◽  
Tumor Removal ◽  
Nerve Preservation ◽  
Tumor Capsule ◽  
Acoustic Neuromas ◽  
Dissection Technique

The retrosigmoid (suboccipital) approach is the workhorse for most acoustic neuromas in the cerebellopontine angle. In this operative video atlas manuscript, the authors demonstrate the nuances of the subperineural dissection technique for microsurgical resection of an acoustic neuroma via the retrosigmoid transmeatal approach. The plane is developed by separating the perineurium of the vestibular nerve away from the tumor capsule. This perineurium provides a protective layer between the tumor capsule and the facial nerve which serves as a buffer to avoid direct dissection and potential trauma to the facial nerve. Using this technique during extracapsular tumor dissection helps to maximize the extent of tumor removal while preserving facial nerve function. A gross total resection of the tumor was achieved, and the patient exhibited normal facial nerve function (Fig. 1). In summary, the retrosigmoid transmeatal approach with the use of subperineural dissection are important strategies in the armamentarium for surgical management of acoustic neuromas with the goal of maximizing tumor removal and preserving facial nerve function (Fig. 2).The link to the video can be found at: https://youtu.be/L3lPtSvJt60.

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