Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-16T11:19:26.090Z Has data issue: false hasContentIssue false
  • English
  • Français

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.
Get access Rights & Permissions [Opens in a new window]

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

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Beatty, C. W., Ebersold, M. J., Harmer, S. G. (1987) Residual and recurrent acoustic neuromas. Laryngoscope, 97: 1168–1171.CrossRefGoogle ScholarPubMed
Bentivoglio, P., Cheesman, A. D., Symon, L. (1988) Surgical management of acoustic neuromas during the lastfive years. Part II: Results for facial and cochlear nerve function. Surgical Neurology, 29: 205–209.CrossRefGoogle ScholarPubMed
Birzgalis, A., Ramsden, R. T. (1991) Intravestibular schwannoma Journal of Laryngology and Otology (in press).CrossRefGoogle Scholar
Curley, J. W. A., Ramsden, R. T., Lye, R. H., Howell, A., Healey, K. (1990) Oestrogen and progesterone receptors in acoustic neuromas. Journal of Laryngol and Otology, 104: 865–867.CrossRefGoogle Scholar
Gatehouse, S. (1990) Modelling of disability in unilateral hearing loss, Audiology. In press.Google Scholar
House, J. W., Brackmann, D. E. (1985) Facial nerve grading system, Otolaryngology—Ilead and Neck Surgery, 93: 146–147.CrossRefGoogle ScholarPubMed
King, T. T. (1988) Surgical approaches to acoustic tumours. British Journal of Neurosurgery, 2: 433–438.CrossRefGoogle Scholar
King, T. T., Morrison, A. W. (1980) Translabyrinthine and transtentorial removal of acoustic tumours. Results in 150 cases. Journal of Neurosurgery, 52: 210–216.CrossRefGoogle Scholar
Luetje, C. M. (1989) Intraoperative monitoring: hardware addiction is no substitute for clinical judgement. Editorial. American Journal of Otology 10(5).Google Scholar
Lye, R. H., Dutton, J., Ramsden, R. T., Occleshaw, J. V., Ferguson, I. T., Taylor, I. (1982) Facial nerve preservation during surgery for removal of acoustic nerve tumours. Journal of Neurosurgery, 57: 739–746.CrossRefGoogle Scholar
May, M. (1986) In The Facial Nerve (May, M.. ed). Thieme Inc; New York. p 33.Google Scholar
Moffat, D. A., Croxson, G. R., Baguley, D. M., Hardy, D. G. (1989a) Facial nerve recovery after acoustic neuroma tumour removal. Journal of Laryngology and Otology. 103: 169–172.CrossRefGoogle Scholar
Moffat, D. A., Hardy, D. G., Baguley, D. (1989b) Strategy and benefits of acoustic neuroma searching. Journal of Laryngology and Otology. 103: 51–59.CrossRefGoogle ScholarPubMed
Parkes, J. D. (1985) In Sleep and its disorders, W. B. Saunders & Co; London. p 23–24.Google Scholar
Robson, A. K., Clarke, P., Dilkes, M., Maw, A. R. (1989) Transmastoid extracranial repair of CSF leaks following acoustic neuroma resection. Journal of Laryngology and Otology, 103: 842–844.CrossRefGoogle ScholarPubMed
Siglock, T. J., Rosenblatt, S. S., Finck, F., House, W. F., Hitzelberger, W. E. (1990) Sex Hormone Receptors in Acoustic Neuromas. American Journal of Otology, 11: 237–239.Google ScholarPubMed
Stack, J. P., Ramsden, R. T., Antoun, N. M., Lye, R. H., Isherwood, I., Jenkins, J. P. R. (1988) Magnetic resonance imaging of acoustic neuromas: the role ofgadolinium-DTPA. British Journal of Radiology 61: 800–805.CrossRefGoogle Scholar
Thomsen, J., Tos, M. (1990) Acoustic neuroma: clinical aspects, audiovestibular assessment, diagnostic delay and growth rate. American Journal of Otology, 11: 12–19.Google ScholarPubMed
Vafadis, J. A., Page, R. D., Keith, A., Lye, R. H., Dutton, J., Ramsden, R. T. (1987). Diagnosis and management of acoustic neuroma: a ten year experience. Scientific Exhibit. The Eighth European Association of Neurological Surgeons Congress. Barcelona. September 1987.Google Scholar
Valvassori, G. E., Guzman, M. (1989) Growth rate of acoustic neuromas. American Journal of Otology, 10: 174–176.Google ScholarPubMed
Wiet, R. J., Young, N. M., Monsell, E. M., O'Connor, C. A., Kazan, R. (1989) Age considerations in acoustic neuroma surgery: the horns of a dilemma. American Journal of Otology, 10: 177–180.Google ScholarPubMed