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Retromastoid Microsurgical Approach to Vascular Compression of the Eighth Cranial Nerve
Author(s) -
Leclercq Toussaint A.,
Hill Charles L.,
Grisoli Francois
Publication year - 1980
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1002/lary.1980.90.6.1011
Subject(s) - medicine , tinnitus , vertigo , neurovascular bundle , surgery , vestibular system , microvascular decompression , cerebellopontine angle , decompression , chin , nausea , microsurgery , vestibular nerve , anesthesia , anatomy , audiology , radiology , trigeminal neuralgia , magnetic resonance imaging
In our series of 10 patients, the age ranged between 31 and 69 years. Seven patients were followed for from 1–2½ years. Complaints consisted of tinnitus, vertigo, or both. Vegatative symptoms consisting of nausea or vomiting were minimal or absent. Audiometry revealed a varying neurosensory loss. Vestibular hypoexcitability was a common finding. Good discrimination appeared to indicate a vascular loop rather than hydrops. The neuroradiologic work‐up was unremarkable. Treatment consisted of neurovascular decompression of the VIIIth nerve by microdissection. The approach used was a retromastoid incision with a bony removal limited to 20 mm. Cerebrospinal fluid withdrawal and lateral decubitus positioning permitted visualization of the VIIIth nerve without retraction of the cerebellum. Lack of bleeding, rapidity of procedure and benign postoperative course are emphasized. The results on tinnitus and vertigo were satisfactory. No additional deficit was created by surgery. If the symptoms are significantly disabling, microsurgical exploration is indicated.