[Possibilities of preserving hearing in the surgery of acoustic neurinoma].

Between 1981 and 1984, 44 patients underwent acoustic neurinoma removal by a posterior cranial fossa approach in an attempt to preserve hearing. 7 tumors were small (less than 20 mm), 28 were medium (20 to 40 mm) and 9 large (greater than 40 mm). Of these 44 patients, 4 had normal hearing preoperatively, 15 had serviceable hearing, 10 non-serviceable hearing and 15 anacousis. Postoperative hearing was preserved in 11 cases. Of the 19 patients with normal or serviceable hearing, 8 (42%) had serviceable hearing preserved postoperatively. Hearing preservation was achieved in 43% of small tumors, 25% of medium tumors and 11% of large tumors. This study stress the importance of the suboccipital approach which can be used in an attempt of hearing preservation whenever the patients have serviceable hearing preoperatively and whenever the tumor size makes it feasible.