Translabyrinthine Extirpation of a Neurinoma of the Acoustic Nerve at the ENTClinic Faculty Hospital and Policlinic Ostrava

Overview

The authors the case-record of a female patient with a neurinoma of the acoustic nervewhich was successfully operated by a translabyrinthine approach and they discuss ontoneurologicalissues associated with this problem.The translabyrinthine approach to a neurinoma of the acoustic nerve makes a very effective clearapproach to the tumour possible, in particular as regards visualization of the facial nerve throug-hout, the operation. It provides adequate orientation in the cerebro-cerebellar angle. If necessary,the approach can be extended and thus the size of the tumour is not a limiting factor of the surgicalprocedure. The authors describe pitfalls in case of an amply pneumatized bone which involve thedanger of opening of the sinus tympani and inadequate tamponade of the attic at the end of theoperation. The first danger was overcome in the described case. Perfect closure on the defect of thedura mater, filling of the trepanation cavity and tamponade of the attic was achieved only by twostrips of adipose tissue from the hypogastrium and by extraction of the incus. The patient has noinnervation lesion of the facial nerve and during the 2.5 year follow up after surgery there are nosigns of relapse of the tumour.

Key words:
neurinoma of the acoustic nerve, translabyrinthine approach.