The neuro-otologist's view of the surgical management of acoustic neuromas.

The experience of our group in the management of 1667 patients with the diagnosis of an acoustic neuroma has been reviewed. Certain features of the operation have been discussed. It is our feeling at this time that with the techniques available to the neuro-otologist for the management of patients harboring acoustic neuromas, the goals of surgery should be total removal of the tumor with preservation of the facial nerve and avoidance of injury to the adjacent important brain structures. Our patients, at this time, should reasonably expect this type of result from their surgery. Hearing preservation in the above framework continues to be frustrating and difficult to consistently attain, and obviously remains the next barrier in acoustic tumor surgery.