THERE is no question that total removal is the treatment of choice in acoustic tumor surgery. However, at the time of surgery there are a number of considerations which occasionally make total removal inadvisable.
In 1925, Dandy1 recommended total removal of acoustic tumors at the initial operation in all cases. He noted, as have other surgeons, that the second operation for acoustic tumor had a high mortality rate. This was believed to be due primarily to adhesions that developed in the posterior fossa which obscured the surgical planes and increased the bleeding, thus making injury to such structures as the cerebellum and brain stem much more likely. Dandy's concept, therefore, was that it would be better to remove the tumor totally at the first operation and thereby increase the initial operative mortality to some degree rather than face the vastly increased mortality of a second operation. In this way he
House WF. Partial Tumor Removal and Recurrence in Acoustic Tumor Surgery. Arch Otolaryngol. 1968;88(6):644–654. doi:10.1001/archotol.1968.00770010646013
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