ISSN 1308-7649 | E-ISSN 2148-3817
Original Article
Complications of the Middle Cranial Fossa Approach for Acoustic Neuroma Removal
1 Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital of Wuerzburg, Wuerzburg, Germany  
2 Department of Otorhinolaryngology, University Hospital of Rostock, Rostock, Germany  
3 Department of Otorhinolaryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery, University Hospital of Wuerzburg, Wuerzburg, Germany  
J Int Adv Otol 2017; 13: 186-190
DOI: 10.5152/iao.2017.3585
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Key Words: Complications, acoustic neuroma, vestibular schwannoma, microsurgery, middle cranial fossa approach
Abstract

OBJECTIVE: To analyze postoperative complications after microsurgery for acoustic neuroma (AN) via the middle fossa approach (MFA).

 

MATERIALS and METHODS: In total, 203 consecutive patients of a tertiary skull base referral center at a university hospital were included in this retrospective chart and database analysis. All patients had undergone primary microsurgery at the Otorhinolaryngology department via MFA between December 2005 and October 2014. Postoperative complications were documented during the inpatient stay and outpatient follow-up.

 

RESULTS: Overall, 41 complications were registered in 35 patients. The most common was cerebrospinal fluid (CSF) leakage in 13% of the patients. Bleeding complications were documented in seven patients: two cerebellar bleedings, one subdural and one epidural hematoma, two hematomas of the skin, and one bleeding through the closed wound. Two patients experienced meningitis and one patient had a transient ischemic attack. Furthermore, three cases of deep vein thrombosis occurred, which led to a lethal pulmonary embolism in one case. One patient sustained temporary palsy of the vocal fold and another reported antibiotic-associated diarrhea.

 

 

CONCLUSION: Acoustic neuroma surgery via the MFA can be conducted with low morbidity and mortality. The most common complication is CSF leakage, which can be treated in most cases in a stepwise conservative manner. Severe adverse events that may require revision surgery are very scarce (1%).

 

Cite this article as: Scheich M, Ginzkey C, Ehrmann-Müller D, Shehata-Dieler W, Hagen R. Complications of the Middle Cranial Fossa Approach for Acoustic Neuroma Removal. J Int Adv Otol 2017; 13: 186-90. 

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