Jppm. Vanleeuwen et al., TRANSLABYRINTHINE AND TRANSOTIC SURGERY FOR ACOUSTIC NEUROMA, Clinical otolaryngology and allied sciences, 19(6), 1994, pp. 491-495
The results and complications of translabyrinthine and transotic surge
ry for petrous apex lesions between 1980 and 1992 are presented. An ac
oustic neuroma was found in 52 patients. In 1988, the translabyrinthin
e approach was modified into the transotic approach and replaced the f
ormer technique. There was no mortality in this series, but two patien
ts had mild brainstem infarcts and there was post-operative bleeding i
nto the cerebellopontine angle in one. Cerebrospinal fluid (CSF) leaka
ge was seen in six patients and meningitis in two. Three suffered deep
vein thrombosis in their legs. There was one case each of herniation
of the cerebellum and gastric bleeding. Post-operative facial nerve fu
nction was good in 88%, moderate in 10% and poor in 2%. In the case of
acoustic neuromas the aim was total tumour removal, but if there was
a serious risk of damaging the nerve anatomically, near total or subto
tal removal was performed. During the study period, there was a gradua
l decrease in facial nerve morbidity and surgical complications. This
was attributed to increasing experience, the modified wider approach a
nd better post-operative care.