Management of the large acoustic tumor.

Abstract

THE TECHNIQUE of the transsigmoid approach to the cerebellopontine angle for the management of large acoustic tumors has previously been reported. 1 It will be the purpose of this paper to summarize those cases in this series who underwent this operation. Evolution of the Transsigmoid Operation The authors have felt that in those patients harboring large acoustic tumors extending below the level of the jugular bulb and associated with multiple cranial neuropathy, the translabyrinthine, middle fossa, and suboccipital operations all have deficiencies. Basically, a procedure has been needed which would allow access to the inferior pole of the tumor, decompression of the posterior fossa, preservation of the facial nerve, and total removal of the tumor. The suboccipital approach allows access to the inferior pole of the tumor and decompression of the posterior fossa, but usually at the price of retraction or resection of the lateral cerebellar hemisphere. In addition, of