MIDDLE FOSSA APPROACH FOR HEARING PRESERVATION WITH ACOUSTIC NEUROMAS

Objective: This study aimed to provide a clinical review of middle fos sa approach for hearing preservation in acoustic neuroma surgery. Stud y Design: This was a prospective case review. Setting: The study was p erformed in a tertiary referral center of a private otologic practice. Patients: One hundred fifty-one consecutive middle fossa approaches f or removal of acoustic neuroma were used. The 91 males and 60 females ranged in age from 10-72 years with a mean age of 48 years. Tumor size ranged from 0.5-2.5 cm, with a mean of 1.2 cm. Main Outcome Measures: House-Brackmann facial nerve grade and hearing level classified both by the American Academy of Otolaryngology-Head and Neck Surgery criter ia for reporting results of hearing preservation surgery and by compar ison with preoperative level (15 dB/15%) were the main outcome measure s. Result: Measurable hearing was preservation in 68%, with 52% within 15 dB and 15% discrimination. Excellent facial function (House-Brackm ann grade I-If) was obtained in 95% of patients. Conclusion: The middl e fossa craniotomy approach for acoustic neuroma is a reliable approac h with a good hearing preservation rate and excellent facial nerve fun ction outcome. Complications are minimal in this group of patients.