Microsurgical resection of large acoustic neuroma through the retrosigmoid approach: a clinical analysis

Objective To discuss the surgical skills in microsurgical resection of large acoustic neurornas via the retrosigmoid approach for reducing the neural damage and complications of such surgeries. Methods Twenty-one cases of large acoustic neuroma treated with microsurgery via the retrosigmoid approach were retrospectively analyzed in view of the surgical approach, microsurgical techniques, intraoperative accidents, and management of the postoperative complications. Results The tumors were totally removed in 18 cases and subtotally in 3 cases. The facial nerve function was well preserved in 17 cases (80.9%), and the acoustic nerve was preserved in 5 cases (23.8%). Intraoperative cardiac arrest occurred in 1 case, and 4 patients developed short-term postoperative complications, but no death occurred in these cases. Conclusion Microsurgical resection through the retrosigmoid approach is safe for removal of large acoustic neuroma, and proficient microsurgical skills and thorough understanding of the microanatomy are crucial for total tumor resection and reduction of the nerve injuries and surgical complications. Key words: Retrosigmoid approach; Acoustic neuroma; Microsurgical operation