The small acoustic tumour; a chance to preserve hearing.

The authors report their experience in the surgical management of small (less than 1.5 cm diameter) acoustic neuromas. Twenty-nine patients were treated. They had suffered symptoms of unilateral eighth nerve dysfunction on average for 37 months. High resolution CT with iv contrast was the primary investigation. In equivocal cases, air meatography was performed. All operations were performed by the senior author (LS). All tumours were totally removed, there were no deaths and all patients had an excellent result. There were 6 complications (CSF leak 3; meningitis 2; deep venous thrombosis 1). The facial nerve was preserved in 26 cases (and functioned adequately in all) and the cochlear nerve in 62%. In 4 cases with hearing pre-operatively, the decibel loss was the same or less post operatively. In 8 cases speech discrimination remained above 35%.