초록 close

Objective:In order to facilitate total removal with preservation of the facial nerve, the authors applied presigmoid(PS) approach in some patients with recurrent acoustic neurinoma(AN) patients who had undergone previous retrosigmoid(RS) approaches. The surgical outcomes of PS approach were retrospectively analyzed and compared to those of RS approaches and we suggest the indication of PS approach for recurrent AN. Methods:From 1989 to 1999, twenty-one of 183 operated AN patients underwent re-operation due to regrowth of the residual tumors. Nine of the 21 recurrent tumors were removed by PS approach and 12 cases underwent RS approach. The surgical extent of removal and the facial nerve preservation rate were compared between the two different approaches. Results:In PS approaches, the total removal was achieved in four patients(44%) and the facial nerve could be identified and preserved anatomically in all patients. Among 12 cases who underwent RS approaches, the rate of total removal was 44% and the facial nerve identified and preserved in only 5 cases (42%). The rate of facial nerve preservation was significantly different between two modes of approaches (p=0.0007). Conclusion:PS transpetrosal approach is recommended in recurrent AN patients who had underwent RS approach previously and already lost the hearing. Early identification of the facial nerve and easy removal of the tumors can be achieved using the PS approach. Key words:Recurrence;Acoustic neurinoma;Retrosigmoid approach;Presigmoid approach;Facial nerve.