J Korean Neurosurg Soc.  1996 Dec;25(12):2425-2430.

Surgical Results of Large Acoustic Neurinomas: Preoperative Prediction of Facial Nerve Displacement by MRI

• Jung S
• Kim TS
• Kim JH
• Kim SH
• Kang SS
• Lee JH

Abstract

A total of 22 patients(13 males and 9 females;mean age 49 years) with large acoustic neurinoma who underwent the retrosigmoid transmeatal approach from May 1993 to May 199 at the Chonnam University Hospital was reviewed retrospectively. The authors investigated the surgical results and accuracy in predicting the direction of displaced facial nerve which was determined by preoperative magnetic resonance(MRI) findings. In all cases the preferred method was the suboccipital transmeatal approach. The direction of displacement of the facial nerve could be predicted by preoperative axial and coronal MRI scans and verified intraoperatively. Gross total removal was performed in 82%, the accuracy rate for facial nerve displacement was 77% and anatomical preservation was accomplished in 82.3% of the totally removed cases. During follow-up, good functional outcomes were achieved in 91% and fair in 4.5%. The authors conclude that such good surgical results can be attributed to advances in microsurgical technique and intr aoperrative facial monitoring. In addition, preoperative prediction of the direction of displaced facial nerves has significantly reducd the incidence of severe facial nerve weakness.

Keyword

Large acoustic neurinoma; Prediction of facial nerve; Retrosigmoid transmeatal approach

MeSH Terms

Acoustics*
Facial Nerve*
Follow-Up Studies
Humans
Incidence
Jeollanam-do
Magnetic Resonance Imaging*
Male
Neuroma, Acoustic*
Retrospective Studies