Microsurgery via suboccipito retrosigmoid approach for large acoustic neuromas

ObjectiveTo report our experience in treating large acoustic neuromas by microsurgery through suboccipito retrosigmoid approach.MethodsThe clinical data of 182 patients with large acoustic neuroma, who underwent microsurgery through suboccipital retrosigmoid approach from January 2008 to December 2011, were analyzed retrospectively. Forty-eight patients received intraoperative electrophysiological monitoring and 20 did not use from October 2012 to December 2011.ResultsTotal resection was achieved in 162 patients(89.0%), subtotal in 12 and partial in 8. The anatomical preservation rate of the facial nerve was 92.3%(168/182). The facial nerve function was preserved in 127 patients(69.8%) one week after operation. Four patients died after operation. The functional preservation rate of the facial nerve(89.5%, 43/48) was significantly higher in the patients receiving intraoperative neurophysiological monitoring than those did not(70.0%, 14/20;P0.05). One hundred and forty-six patients were followed up for 3~12months; the functional preservation rate of the facial nerve was 82.9%.ConclusionsMicrosurgery through suboccipito retrosigmoid approach is an effective method for large acoustic neuromas. The intraoperative neurophysiological monitoring helps to increase the functional preservation rate of the facial nerve.