{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,26]],"date-time":"2026-02-26T12:43:23Z","timestamp":1772109803275,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[1994,2,1]],"date-time":"1994-02-01T00:00:00Z","timestamp":760060800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[1994,2]]},"abstract":"<jats:p>Between March 1966 and September 1992, 1400 acoustic neuromas were treated in Paris, France, by surgical excision. The findings over the last 7 years are presented. The <jats:italic>translabyrinthine approach<\/jats:italic> has been used in more than 85% of cases. Where hearing preservation is attempted, the <jats:italic>middle fossa approach<\/jats:italic> has been adopted for intracanilicular tumors and the <jats:italic>retrosigmoid approach<\/jats:italic> for small tumors extending into the cerebellopontine angle, in which the fundus of the internal meatus is free of tumor. The main goal is to achieve a grade I or II result in facial function within 1\u00a0month of surgery. Results improved during 1991 after the introduction of continuous facial nerve monitoring and the use of the Beaver mini\u2010blade for dissection of tumor from nerve. With these techniques, facial function at grade I or II at 1\u00a0month improved from 20% to 52% for large tumors (larger than 3\u00a0cm), from 42% to 81% for medium tumors (2 to 3\u00a0cm), and from 70% to 92% for small tumors (up to and including 2\u00a0cm extracanalicular). The facial nerve was at greater risk using the retrosigmoid or middle fossa approaches than by the translabyrinthine route. Since 1985, success in hearing preservation has changed little, with useful hearing being preserved in 38.2% of cases operated on by means of the retrosigmoid route and 36.4% of cases after the middle fossa approach. In older patients with good hearing and small tumors, observation with periodic MRI scanning is recommended. Despite earlier diagnosis, the number of patients suitable for hearing preservation surgery remains very limited and careful selection is required. Trigeminal nerve signs were present in 20% of cases preoperativey, in 10% postoperatively, and recovered spontaneously. Palsies of the other cranial nerves after surgery were much rarer and were as follows: sixth nerve (abducens), 0.5%; ninth nerve (glossopharyngeal), 1.4%; and tenth nerve (vagus), 0.7%. The importance of preservation of function of the nervus intermedius of Wrisberg is stressed. These results emphasize the advantages of the translabyrinthine approach, offering greater security to the facial nerve and lower morbidity.<\/jats:p>","DOI":"10.1177\/019459989411000202","type":"journal-article","created":{"date-parts":[[2015,11,25]],"date-time":"2015-11-25T06:51:44Z","timestamp":1448434304000},"page":"146-155","source":"Crossref","is-referenced-by-count":89,"title":["Preservation of facial, cochlear, and other nerve functions in acoustic neuroma treatment"],"prefix":"10.1002","volume":"110","author":[{"given":"Jean\u2010Marc","family":"Sterkers","sequence":"first","affiliation":[{"name":"ORL des Hopitaux de Paris Paris France"}]},{"given":"Gavin A. J.","family":"Morrison","sequence":"additional","affiliation":[{"name":"Department of ORL Hopitaux de Parism Hopital Beaujon Clichy France"}]},{"given":"Olivier","family":"Sterkers","sequence":"additional","affiliation":[{"name":"Department of ORL Hopitaux de Parism Hopital Beaujon Clichy France"}]},{"given":"Mohamed M. 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