Acoustic tumor surgery with preservation of hearing. A histopathologic report.

The goals of acoustic tumor surgery are total tumor removal, intact facial nerve function, and preservation of hearing. the middle fossa approach offers the opportunity to achieve these goals in selected cases. This article presents the findings from the temporal bones of two patients who had undergone middle fossa removal of an acoustic tumor, nine and ten years before their deaths. Hearing was preserved in one case and lost in the other. The patient with profound postoperative deafness showed severe degenerative changes and ossification in the membranous labyrinth. This was explained on the basis of internal auditory artery occlusion. The goals of acoustic tumor surgery are discussed in light of the histopathologic findings in these two cases. the middle fossa approach is advocated as the best available to achieve these goals in intracanalicular tumors.