S. Rushdan, DS Sidek, M. Hamzah, J. Abdullah.
Department Otolaryngology-Head and Neck, Unit Neurosurgery,
Hospital Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan,
Malaysia.
Translabrynthine approach for acoustic Neuromas are not commonly done in Malaysia. We report a combined Otolaryngological-Neurosurgical management for a left sided medium size acoustic neuroma, the first case in Hospital Universiti Sains Malaysia.
This 60 years old Malay male with left sensorineural deafness was referred to the Neurosurgical unit due to dizziness and tinnitus as well less of hearing from the left ear. Neurological examination revealed only left sided sensorineurol deafness and a House and Braakman grade facial nerve function of grade 1. An audiometry revealed left near-total deafness. A computed Tomographic and Magnetic Resonance Imaging of the brain revealed a middle sized acoustic Neuroma.
A translabrynthine approach to the left acoustic Neuroma was done in
lateral position. Under microscopic guidance the temporal and mastoid sections
were removed using a high- speed drill. The acoustic Neuroma capsule was
opened and its contents removed. The facial nerve was spared.
Result: Postoperatively patient developed a House and Braakmann facial
nerve function grade of 3 which improved with steroids and physiotherapy.
Conclusion: Translabrynthine approach to acoustic Neuromas is an elegant
method of removal of small and middle sized acoustic Neuromas and will
be done especially for cases with total or neartotal sensori-neural deafness.