Bilateral acoustic tumors: its clinical features and surgical treatment.

Abstract

The authors have experienced 18 cases of bilateral acoustic tumors. They were found to occur most often in relatively young subjects and often to be associated with von Recklinghausen's disease. In spite of the existence of bilateral tumors, the patients frequently retained unilateral auditory function. Visual disturbance due to secondary optic atrophy was observed occasionally. The mortality rate of operation was fairly high. The cause of death was mostly brainstem damage induced by simultaneous removal of large bilateral tumors. In many of the surviving patients, auditory function was sacrified in spite of fair postoperative course. The most advisable stratagem for surgery is thought to be as follows. 1) Bilateral large tumors should be submitted to surgery in two sessions. 2) The maintenance of residual hearing function should be considered superior to radical removal of tumors. 3) Decompressive craniectomy alone is not effective.