Optimal Approach to Tumours of the Postcerebellar
Angle. Universal Path or Eclectic Philosophy in the Seletion of the Approach
Mrázek J., Paleček T., Wolný E., Mrázková E.
Klinika otorinolaryngologie a chirurgie hlavy a krku FNsP Ostrava, přednosta doc. MUDr. J. Mrázek, CSc. Neurochirurgická klinika FNsP Ostrava, přednosta MUDr. T. Paleček |
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Summary:
A more varied selection of approaches to the inner auditory meatus and pontocere-
bellar angle gives the patient a better chance of postoperative morbidity not only as regards early
postoperative complications but also from the aspect of the function of the facial nerve and
preservation of hearing. The authors analyzed a group of 136 operated unilateral schwannomas,
incl. 131 operated from a retrosigmoid approach, three from a translabyrinthine approach and two
via the middle cranial fossa. The middle cranial fossa approach is the most considerate surgical
method. It can be used only in small intracanalicular schwannomas, further selection depending
on ENG, BERA and NMR findings. The translabyrinthine and retrosigmoid approach is usually
selected in an attempt to preserve acceptable hearing, the translabyrinthine approach could be
used preferentially where hearing cannot be preserved. This procedure has as a rule smaller
postoperative complications than the retrosigmoid approach.v
Key words:
vestibular schwannoma, route of approach, extirpation.
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