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October 1987

Hearing Conservation in Acoustic Neuroma Surgery

Arch Otolaryngol Head Neck Surg. 1987;113(10):1047. doi:10.1001/archotol.1987.01860100025014

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At the 1987 April meeting of the American Otological Society in Denver, Jack L. Pulec, MD, and Stephen L. Giannotta, MD, Los Angeles, presented their experience with hearing conservation in acoustic neuroma surgery. The senior author (Dr Pulec) has had the opportunity of attempting to conserve hearing on 12 cases of acoustic neuroma over the last 25 years. Of these 12 cases, eight cases had serviceable hearing postoperatively, while in four cases the hearing was lost. His surgical approach is via the middle cranial fossa, and he feels that the best prognostic factors are the location and size of the túmor. Patients who have acoustic neuromas arising from the inferior vestibular nerve have a poor prognosis, probably because the vascular supply to the cochlea is embarrassed during removal of the tumor. Preoperatively, one might be able to anticipate the inferior vestibular nerve origin of the tumor by the presence of

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