Facial function in hearing preservation acoustic neuroma surgery

Objective: To determine if facial function is worse after hearing preservation acoustic neuroma surgery (retrosigmoid and middle fossa) than in translabyrinthine surgery. Design: Retrospective medical record review. Setting: Private neuro-otology subspecialty practice of patients operated on in a tertiary care hospital. Patients: This study evaluated 315 consecutive acoustic neuroma surgical procedures between April 1989 and July 1998. A total of 209 translabyrinthine procedures and 106 hearing preservation surgical procedures were performed. The hearing preservation procedures were equally divided between retrosigmoid (n=48) and middle fossa (n= 58) procedures. Methods: Medical records were reviewed and tabulated for tumor size, surgical approach, and House-Brackmann facial function grade at short-, intermediate-, and long-term intervals. Results: Postoperative facial function in hearing preservation surgical procedures at short- and long-term follow-up was not worse than facial function after translabyrinthine surgical procedures in comparably sized tumors. Conclusion: Concern about postoperative facial function should not be the deciding factor in selecting hearing preservation vs nonhearing preservation acoustic neuroma surgery.