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Acoustic neuroma (schwannoma) surgery 1978–1990

Published online by Cambridge University Press:  29 June 2007

J. E. M. Dutton ,
R. T. Ramsden ,
R. H. Lye ,
K. Morris ,
A. O. Keith ,
R. Page  and
J Vafadis
J. E. M. Dutton
Affiliation:
Manchester
R. T. Ramsden*
Affiliation:
Manchester
R. H. Lye
Affiliation:
Manchester
K. Morris
Affiliation:
Manchester
A. O. Keith
Affiliation:
Manchester
R. Page
Affiliation:
Manchester
J Vafadis
Affiliation:
Manchester
*
Mr Richard T. Ramsden F.R.C.S., Department of Otolaryngology, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL.
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Abstract

A series of 151 patients with 154 acoustic schwannomas have been operated upon in Manchester Royal Infirmary by a joint Otological and Neurosurgical team, employing either the translabynnthine or the sub-occipital approach. The perioperative mortality rate was 3 per cent. Anatomical preservation of the facial nerve was achieved in 89 per cent of tumour removals and a good to normal functional result in 79 per cent of cases. Attempts at hearing preservation have been unsuccessful, largely because of the small number of patients in the series in whom useful hearing was present preoperatively. Complications included major brain stem ischaemia (1.2 per cent), CSF fistula (5 per cent) and facial dysaesthesia (7 per cent). The incidence of mortality and morbidity is directly related to tumour size and to the experience of the surgeons. A number of patients experienced an unusual type of post-operative dreamlike state which appeared to be a form of hypnagogic hallucination, and the possible neurophysiological mechanism responsible for this phenomenon is discussed. The continuing failure to attain the ideal of early diagnosis is lamented, and the importance of a flexible bidisciplinary surgical approach emphasized.

Keywords

Acoustic schwannoma
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 105 , Issue 3 , March 1991 , pp. 165 - 173
Copyright
Copyright © JLO (1984) Limited 1991

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