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To the Editor.—We have a growing concern that a number of otolaryngologists (even some trained in neurotology) are turning toward the upright suboccipital approach for removal of the acoustic neuroma. Prestigious university centers or large privately endowed clinics are no exception.
While it can be argued that "flexibility," "hearing preservation," and "neurosurgical cooperation" are reasonable considerations, it really comes down to one thing: the willingness of a concerned otolaryngologist to learn the best and most appropriate approach for the patient's well-being. While it can be argued that large tumors are anyone's game, it has been our experience that the translabyrinthine approach or the middle fossa approach are far safer than the upright suboccipital approach. Both of us have had experience in both techniques.
The members of our specialty must be careful to observe the so-called neurotologic team. "What is in a name: 'Neurotology'?" It is really that the neurosurgeon
WIET RJ, SHAMBAUGH GE. The Neurotologic Approach to Acoustic Neuromas: 'What's in a Name?'. Arch Otolaryngol. 1983;109(4):275. doi:10.1001/archotol.1983.00800180073018