TRANSTEMPORAL BONE MICROSURGICAL REMOVAL OF ACOUSTIC NEUROMAS. NEUROSURGICAL THOUGHTS COMPARING SUBOCCIPITAL AND TRANSLABYRINTHINE APPROACHES.

Acoustic neuromas are among the more difficult lesions with which the neurosurgeon has to cope. In every patient the facial nerve is in jeopardy, and in the larger lesions the patient's life is threatened. This tumor accounts for approximately 5% of the intracranial tumors encountered by the neurosurgeon. This affords sufficient experience that he may become skillful in the technique he employs to remove them, but unfortunately he is limited in his ability to preserve life and functioning regional cranial nerves, not so much from a lack of skill, but rather because of limitations imposed by the conventional technique itself. Thus, even in the most skilled hands, the operative approach to this tumor through the subocciput has been associated with sufficient incidence of mortality, morbidity, and damage to the facial and other cranial nerves that there is a need for reduction of this incidence. The otologist who sees most of