The objective of this study was to evaluate the results of
endoscope-assisted
acoustic neuroma surgery in posterior fossa approach. Between 1996 and 2002, 60 consecutive patients with
acoustic neuroma were operated via the retrosigmoid suboccipital approach. Standard 4-mm sinus
endoscopes at different angles were used during the surgeries either for inspection or
tumor endoscopic dissection. Clinical parameters and treatment outcome were evaluated retrospectively.
Tumor sizes were small, medium and large in 46.6, 45 and 8.3% of the patients, respectively. The hearing preservation rate, which did not correlate with
tumor size (p > 0.05), was 24.4%. The need for facial reanimation surgery, which was needed in 5% of patients, was significantly higher in the large
tumors than in the small and medium
tumors (p < 0.001). Cerebrospinal fluid
fistula rate, which was not related to
tumor size (p > 0.05), was 13.3%.
Tumor recurrence or
residual tumor was not encountered at all. In conclusion,
endoscopes give accurate information about the relationship between the
tumor and the adjacent structures and help control the fundus of the internal auditory canal to ensure complete
tumor removal. It is also helpful in visually verifying the continuity of the facial and cochlear nerves. The use of
endoscopes does not appear to increase the hearing preservation rate, but is very helpful in complete
tumor removal in the posterior fossa approach.