Acoustic neuroma surgery. Results and complications in 348 cases]

The aim of this study was to evaluate post-operative complications after acoustic neuroma surgery.This was a retrospective study of 348 patients, who had acoustic neuroma surgery between 1984 and 1999. Symptoms, pre-operative evaluation, surgery and post-operative complications were analysed.174 men and 174 women had an operation. Mean age was 51.8 years (11-78). 31 patients had a grade I tumour, 106 a grade II, 71 a grade III and 140 had a grade IV tumour. 195 patients have been operated through the translabyrinthine approach, 110 through the retrolabyrinthine approach, 42 through the sub-occipital approach, and one through the transcochlear approach. Mortality was 0.85%, 59.2% patients had a post-operative facial paralysis. Most of patients had post-operative dizziness, and 30% still had vestibular disturbances after one year. 9 patients (2.6%) had a cerebrospinal rhinorrhea and 24 patients had a cerebrospinal wound leak (6.9%). 22 patients had post-operative meningitis (6.3%). 2 patients had a cerebello pontine angle haemorrhage, and 3 patients had a brain stem infarct.Transpetrous approaches are safe for acoustic neuroma removal and the post-operative complication rate is low. The retrolabyrinthine approach seems to be a good hearing preservative approach, regardless of tumour volume.