Retroamstoid Suboccipital Approch to Cerebellopontine Angle Tumors

ABSTRACT

Eight patients with cerebellopontine angle tumors larger than 3cm in diameter were operated on through retromastoid suboccipital approach with microsurgical technique. Patients were placed in lateral decubitus position with the head fixed by a three point Mayfield head-pin and the face was turned about fourty degree down as the imaginary petrous ridge directed to the floor, vertically. There are six acoustic neuromas, one meningioma and one hemangioblastoma presented in this report. The total tumor removal was done in all cases but one and the facial nerve was preserved anatomically in six of eight patients and in one of the other two the nerve was anastomosed in the same operative field following tumor excision. Functionally, two cases of facial paresis and one facial paralysis were resulted. Above results show that this approach is just suitable for total removal of the large cerebellopontine angle tumors with preservation of the facial nerve by neurosurgeon under best obtained neuroanatomical knowledge.