Complications in acoustic neuroma removal. Transtemporal, suboccipital, and combined.

THE TECHNICAL skills of the otologic surgeon excel within the temporal bone, and those of the neurosurgeon in the posterior fossa. Between lies the acoustic neuroma. There are several surgical approaches to the removal of these tumors, each having specific advantages and distinct disadvantages, but none is ideal for removal of all tumors. For these reasons we have pooled our skills and utilized a team approach for surgical treatment, selecting the operation based mainly on considerations of tumor size and patient condition. The surgical team approach has not only advanced mutual knowledge, and minimized biased concepts, but offers a broad and comprehensive approach to the total management of the patient with an acoustic nerve tumor. From the outset, our main aim has been for total removal. This has been achieved in 100% of the cases in this series but has necessitated second stage operations in five patients. Since we have