Middle Fossa Approach for Hearing Preservation With Acoustic Neuromas : Otology & Neurotology

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Middle Fossa Approach for Hearing Preservation With Acoustic Neuromas

Slattery, William H. III*; Brackmann, Derald E.*; Hitselberger, William

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The American Journal of Otology 18(5):p 596-601, September 1997.


Objective: This study aimed to provide a clinical review of middle fossa approach for hearing preservation in acoustic neuroma surgery.

Study Design: This was a prospective case review.

Setting: The study was performed in a tertiary referral center of a private otologic practice.

Patients: One hundred fifty-one consecutive middle fossa approaches for removal of acoustic neuroma were used. The 91 males and 60 females ranged in age from 10–72 years with a mean age of 48 years. Tumor size ranged from 0.5–2.5 cm, with a mean of 1.2 cm.

Main Outcome Measures: House-Brackmann facial nerve grade and hearing level classified both by the American Academy of Otolaryngology-Head and Neck Surgery criteria for reporting results of hearing preservation surgery and by comparison with preoperative level (15 dB/15%) were the main outcome measures.

Result: Measurable hearing was preservation in 68%, with 52% within 15 dB and 15% discrimination. Excellent facial function (House-Brackmann grade I—II) was obtained in 95% of patients.

Conclusion: The middle fossa craniotomy approach for acoustic neuroma is a reliable approach with a good hearing preservation rate and excellent facial nerve function outcome. Complications are minimal in this group of patients.

© 1997, The American Journal of Otology, Inc.

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