IF ALL acoustic tumors were the same size when detected, one type of surgical procedure would be adequate for their removal. Now that we are finding these tumors when they are early and confined to the internal auditory canal, it is obvious that the suboccipital approach is not the route of choice in all instances. For that matter, neither is the translabyrinthine, because it is now possible to save the hearing in some of these early cases (see article on Small Tumors). One can arbitrarily divide acoustic tumors into three groups: (1) small (confined to the internal auditory canal); (2) medium (extending out of the canal and into the cerebellopontine angle, but without producing any additional cranial nerve dysfunction); and (3) large (extending into the cerebellopontine angle and associated with other cranial nerve findings, cerebellar findings, or with increased intracranial pressure). In dealing with these different sized tumors, it
Glasscock ME. Surgical Techniques for the Removal of Acoustic Tumors: A System of Operations. Arch Otolaryngol. 1968;88(6):618–627. doi:10.1001/archotol.1968.00770010620009
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