Because of progress in early diagnosis of acoustic neuroma it is now allowed to attack the problem of preservation of hearing in operation of these tumors since the conservation of the facial nerve shows good results. This is justified by the findings, that neuromas are growing in the vestibular nerve. In retrosigmoidal approach, a modification of the suboccipital approach, the patients pontocerebellar angle is reached by a small craniotomy behind the sinus sigmoideus. The cerebellum is protected by lyophilised duramater and retracted by perfusion of mannitol. The interna 2/3 of the inner ear canal is opened by a drill. In total 40 neuromas between 12 and 45 mm were removed by this technique. In tumors until 22 mm (28 cases) it was possible to conserve cochlear function in 14 cases. Function of facial nerve is conserved in all cases but one. This technique is compared with middle fossa and translabyrinthine approach.
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Bremond, G., Garcin, M., Magnan, J.: Progrès en oto-neurochirurgie: l'abord à minima de l'angle ponto-cérébelleux par la voie rétrosinusale. Acta Oto-Rhino-Laryng. Belg.30, 127–144 (1976)
Sterkers, J. M., Hamann, K.-F.: Sur 8 observations de neurinomes bilatéraux, problèmes diagnostiques et thérapeutiques. Ann. otolaryngol. (Paris) (im Druck) (1979)
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Sterkers, J.M., Hamann, K.-. Der retrosigmoidale Zugang — Versuch zur Erhaltung des Gehörs bei Operationen von Akustikusneurinomen. Arch Otorhinolaryngol 223, 463–465 (1979). https://doi.org/10.1007/BF01109633