Acoustic neuromas are regularly operated on at the ENT Clinic of the Medical School. Approximately 100 patients undergo surgery each year. We have three different approaches available, which are used depending on the location and size of the tumour and the condition of the hearing. During each operation, the MKM neuronavigation system from Zeiss and special monitoring procedures are used to monitor nerve function in order to optimise functional preservation, i.e. to protect the facial and auditory nerves.

The transtemporal procedure

The transtemporal procedure
The transtemporal approach via the middle cranial fossa is preferred for small tumours that just fill or slightly protrude into the internal auditory canal. In this procedure, the inner auditory canal is drilled open after lifting the temporal lobe while sparing the inner ear, and the tumour located there is removed while sparing the facial and auditory nerves. The preservation of hearing is successful in about two thirds of cases.

The translabyrinthine approach

The translabyrinthine approach with partial removal of the inner ear through the mastoid is a very safe and less stressful approach for the patient. It is therefore used for older people and for tumours that have already led to extensive destruction of hearing. It can be used for all tumour sizes. The main advantage is the early identification and therefore safe protection of the facial nerve.

The suboccipital approach

The suboccipital approach via the posterior fossa allows the removal of larger tumours that are predominantly located outside the internal auditory canal and reach the brain stem. In many cases, hearing can also be preserved. Due to the necessary displacement of the cerebellum, this approach is primarily recommended for younger patients.

Results:
The suboccipital approach via the posterior fossa allows the removal of larger tumours that are predominantly located outside the internal auditory canal and reach the brain stem. In many cases, hearing can also be preserved. Due to the necessary displacement of the cerebellum, this approach is primarily recommended for younger patients.