Retrosigmoid Approach to Acoustic Neuroma
The Retrosigmoid approach to Acoustic Neuroma is a directed approach to tumors extending intracranially within the cerebellopontine angle. This approach essentially targets these tumor behind the inner ear and behind the mastoid cavity. As the approach does not affect the inner ear, hearing preservation is possible depending on the hearing loss that is present from the tumor effect itself.
For patient with tumors under 2.5 cm extending intracranially with good hearing, we offer a focused retrosigmoid approach. This approach is performed with the utmost care to minimize trauma to the surrounding extracranial muscles and nerves, avoiding the known post op chronic pain syndromes associated with this approach. Our years of experience with this approach, we have proven that a specialized incision and meticulous muscle dissection towards the skull avoids the headaches that may occur with the retrosigmoid approach and that have been described over many years. As we have continued to focus on innovative techniques to improve outcomes for Acoustic Neuroma surgery, we have been able lessen the postoperative headaches with this approach.
Successful hearing preservation with the retrosigmoid approach is a goal, though likelihood of preserving hearing decreases with the size of the tumor, tumor consistency, and cochlear nerve fiber relation to the tumor. During review of the MRI images, specific attention is given to where the tumor traverses to assess preoperatively the likelihood of hearing preservation potential.
