Microsurgery through suboccipital approach for large acoustic neuromas

ObjectiveTo explore the clinical effect of microsurgery through suboccipital approach on large acoustic neuromas.MethodsThe clinical data of 226 patients with large acoustic neuromas who underwent microsurgery through suboccipital approach fromJanuary, 2000 to June, 2014 were analyzed retrospectively. Ninety-three patients received keyhole surgery.ResultsTotal resection ofthe tumors was achieved in 193 patients and subtotal in 33 due to severe adhesion to the facial nerve or the brain stem. Anatomicpreservation of facial nerves was achieved in 205 patients. Of 70 patients with severe hearing loss before the operation, 34 still hadhearing after the operation and 36 not. Hematomas within the tumorous cavities occurred in 4 patients and one patient died after theoperation. The following-up of 177 patients from 2 months to 13 years showed that 143 patients had House-Broukmam grades Ⅰ~Ⅲfacial nerve function and 34 grades Ⅳ~Ⅴ.ConclusionsThe microsurgery through suboccipital approach is a good method to treatacoustic neuromas. For preservation of facial nerve function, the facial nerve monitoring is recommended during microsurgery for largeacoustic neuromas. It is not necessary to totally resect the tumor which severely adheres to the facial nerve or the brain stem. The largeacoustic neuromas may be totally resected by the keyhole surgery, which produces a little operation side injury.