Long-term results of the first 500 cases of acoustic neuroma surgery

OBJECTIVE: This retrospective study focuses on 2 outcome results after surg ical intervention for acoustic neuroma: (1) facial nerve status, and (2) he aring preservation. STUDY DESIGN: A total of 484 patients with an acoustic neuroma. RESULTS: Postoperative facial nerve outcomes were significantly different ( P < 0.001) according to the size of the tumors. Tumor sire had even more in fluence on the immediate postoperative results. In addition, statistical si gnificance (P < 0.05) was demonstrated in comparing facial nerve outcomes w ith the surgeon's surgical experience. We also noted that as the patient's age increases, the likelihood for facial dysfunction may increase for all p ostoperative intervals. The overall success rate of retaining useful hearin g was 27% (26 of 95). Class A hearing was retained in 66% (10 of 15) of cas es operated on through middle fossa approach in the last 5 years. CONCLUSION: This study demonstrates that tumor size and surgeon's experienc e are the most significant factors influencing the facial nerve status and hearing outcome after removal of acoustic neuroma.