{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T15:43:33Z","timestamp":1779896613188,"version":"3.53.1"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,5,17]],"date-time":"2016-05-17T00:00:00Z","timestamp":1463443200000},"content-version":"vor","delay-in-days":4154,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2005,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p><jats:bold>Surgical removal of large (&gt;3\u00a0cm) acoustic neuromas is associated with poor long\u2010term facial nerve function results and higher complication rates. This study analyzes whether long term facial nerve function and the incidence of neurological and vascular complications is improved by resection of large acoustic neuromas in 2 or 3 stages.<\/jats:bold><\/jats:p><\/jats:sec><jats:sec><jats:title>PATIENTS AND METHODS<\/jats:title><jats:p><jats:bold>Among 660 patients who underwent surgical resection of acoustic neuromas between 1989 and 2002 by the senior author (J.M.K.), 34 (5%) patients underwent a staged resection of their large\u2010sized tumors: stage I via a retrosigmoid craniotomy and stage II via a translabyrinthine approach. A retrospective chart review was performed. Tumor size, completeness of tumor removal, tumor recurrence, facial nerve function, and any complications were noted.<\/jats:bold><\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p><jats:bold>The average tumor size was 4.4\u00a0cm with a mean postoperative length of follow\u2010up of 6 years after the last surgery. Thirty\u2010one patients underwent a 2\u2010staged resection and 3 patients underwent a 3\u2010staged resection. After their last surgery, 32 (94%) patients had excellent long\u2010term facial function grades of House\u2010Brackmann (H\u2010B) I, one was H\u2010B III, and one was H\u2010B VI. All patients had a total or near\u2010total (&gt;98%) resection. There were no tumor recurrences on follow\u2010up MRI scans. From these 71 operations, no patients required reoperation for a CSF leak. There were no deaths, strokes, hydrocephalus, or meningitis.<\/jats:bold><\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p><jats:bold>In conjunction with the reported technical refinements, staged resection of large tumors significantly reduces morbidity and improves long\u2010term facial nerve function. 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