{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T10:43:49Z","timestamp":1792665829964,"version":"4.5.0"},"reference-count":120,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,3]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> The authors studied the relationships between tumor size, location, and topographic position relative to the intact facial nerve bundles in acoustic neurinomas to determine the influence of these factors on hearing preservation postoperatively. Consistent topographic relationships were found.<\/jats:p><jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> Four hundred fifty-two patients with acoustic neurinoma treated via a retrosigmoid approach were analyzed with respect to hearing preservation and facial nerve function. One hundred fifteen tumors were identified as small and were categorized as Grades I and II. Patients with Grade I tumors, that is, purely intracanalicular lesions, all had good hearing preoperatively, defined by a less than 50-dB pure tone average and 50% speech discrimination score. All 14 Grade I tumors were removed, resulting in preservation of the patient's hearing by these criteria. There were no particular topographic anatomical relationships associated with these tumors that affected hearing preservation. Grade II tumors, defined as those protruding into the cerebellopontine angle without contacting the brainstem, were found in 101 patients and were divided by size into two grades: IIA (&lt; 1 cm) and IIB (1\u20131.8 cm). In 90 patients with Grade IIA tumors, 72 (89%) of 81 who had preserved hearing preoperatively maintained it postoperatively, and in the 11 patients with Grade IIB tumors, six of whom had good hearing preoperatively, four (67%) had preserved hearing postoperatively. Six morphological types were identified based on their neurotopographic relationships to the elements of the vestibulocochlear nerve.<\/jats:p><jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> Hearing preservation postsurgery by tumor type was as follows: 1A, 92%; 1B, 88%; 1C, 100%; 2A, 83%; 2B, 92%; and 3, 57%. Combined, this represents a hearing preservation rate of 87% after surgical treatment of Grade II acoustic neurinomas. Full nerve function was maintained in 88% of patients with anatomically preserved facial nerves in both Grade I and II tumors. The remaining 12% of patients retained partial function of the facial nerve. Two patients in the series lost anatomical integrity of the nerve due to surgery.<\/jats:p>","DOI":"10.3171\/jns.1998.88.3.0506","type":"journal-article","created":{"date-parts":[[2009,6,16]],"date-time":"2009-06-16T02:25:11Z","timestamp":1245119111000},"page":"506-512","source":"Crossref","is-referenced-by-count":312,"title":["Neurotopographic considerations in the microsurgical treatment of small acoustic neurinomas"],"prefix":"10.3171","volume":"88","author":[{"given":"Wolfgang T.","family":"Koos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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neurinomas.","volume":"29","author":"Samii","year":"1991","journal-title":"Neurosurgery"},{"key":"ref391","doi-asserted-by":"crossref","first-page":"938","DOI":"10.3171\/jns.1984.61.5.0938","article-title":"Use of intraoperative auditory evoked potentials to preserve hearing in unilateral acoustic neuroma removal.","volume":"61","author":"Ojemann","year":"1984","journal-title":"J Neurosurg"},{"key":"ref601","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1017\/S0022215100112897","article-title":"Hearing conservation in acoustic neuroma surgery via the posterior fossa.","volume":"104","author":"Baldwin","year":"1990","journal-title":"J Laryngol Otol"},{"key":"ref741","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1177\/019459988609400312","article-title":"Neurosurgical management of small and intracanalicular acoustic tumors.","volume":"94","author":"Gardner","year":"1986","journal-title":"Otolaryngol Head Neck 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surgery for acoustic neuromas.","volume":"78","author":"Glasscock","year":"1993","journal-title":"J Neurosurg"},{"key":"ref511","first-page":"99","article-title":"Hearing preservation after acoustic neuroma surgery using intraoperative direct eighth nerve monitoring.","author":"Silverstein","year":"1985","journal-title":"Am J Otol Suppl"},{"key":"ref791","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1227\/00006123-198207010-00004","article-title":"Preservation of cochlear nerve function with the aid of brain stem auditory evoked potentials.","volume":"11","author":"Hardy","year":"1982","journal-title":"Neurosurgery"},{"key":"ref21","first-page":"248","article-title":"Acoustic neuroma surgery: otologic medical group results","volume-title":"Neurological Surgery of the Ear.","volume":"2","author":"Brackmann","year":"1980"},{"key":"ref641","first-page":"263","article-title":"The posterior fossa approach for acoustic tumours: preservation of hearing","volume-title":"Neurological Surgery of the Ear.","volume":"1","author":"Buchheit","year":"1977"},{"key":"ref531","first-page":"269","article-title":"Removal of bilateral and unilateral acoustic tumours with preservation of hearing: a comparison of the retrosigmoid and translabyrinthine approach","volume-title":"Neurological Surgery of the Ear.","volume":"2","author":"Sterkers","year":"1980"},{"key":"ref631","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.1017\/S0022215100090009","article-title":"Preservation of hearing in the removal of acoustic neuroma (\u2018Minima\u2019 posterior approach by retrosigmoidal route).","volume":"94","author":"Bremond","year":"1980","journal-title":"J Laryngol Otol"},{"key":"ref571","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1177\/019459988409200211","article-title":"Hearing preservation in patients with acoustic neuromas via the middle fossa approach.","volume":"92","author":"Wade","year":"1984","journal-title":"Otolaryngol Head Neck 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approach.","volume":"92","author":"Wade","year":"1984","journal-title":"Otolaryngol Head Neck Surg"},{"key":"ref381","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1093\/neurosurgery\/25.CN_suppl_1.461","article-title":"Microsurgical suboccipital approach to cerebellopontine angle tumors.","volume":"25","author":"Ojemann","year":"1978","journal-title":"Clin Neurosurg"},{"key":"ref1021","doi-asserted-by":"crossref","first-page":"158","DOI":"10.3171\/jns.1968.28.2.0158","article-title":"Preservation of vestibular, cochlear, and facial nerves during microsurgical removal of acoustic tumors. 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A classification of results.","volume":"95","author":"Silverstein","year":"1986","journal-title":"Otolaryngol Surg Head Neck"},{"key":"ref911","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1017\/S0317167100027232","article-title":"Electrophysiological monitoring during acoustic neuroma and other posterior fossa surgery.","volume":"15","author":"Linden","year":"1988","journal-title":"Can J Neurol Sci"},{"key":"ref371","first-page":"498","article-title":"Management of acoustic neuromas (vestibular schwannomas).","volume":"40","author":"Ojemann","year":"1993","journal-title":"Clin Neurosurg"},{"key":"ref941","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1288\/00005537-199210000-00010","article-title":"Preservation of hearing and facial nerve function in resection of acoustic neuroma.","volume":"102","author":"Nadol","year":"1992","journal-title":"Laryngoscope"},{"key":"ref551","doi-asserted-by":"crossref","first-page":"637","DOI":"10.2176\/nmc.19.637","article-title":"Microsurgery for acoustic neurinoma\u2014lateral position and preservation of facial and cochlear nerves.","volume":"19","author":"Sugita","year":"1979","journal-title":"Neurol Med Chir"},{"key":"ref871","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1007\/BF01401974","article-title":"Criteria for preservation of vestibulocochlear nerve function during microsurgical removal of acoustic neurinomas.","volume":"92","author":"Koos","year":"1988","journal-title":"Acta Neurochir"},{"key":"ref661","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/0090-3019(93)90036-Z","article-title":"The preservation of hearing and facial nerve function in a consecutive series of unilateral vestibular nerve schwannoma surgical patients (acoustic neuroma).","volume":"39","author":"Cerullo","year":"1993","journal-title":"Surg Neurol"},{"key":"ref581","doi-asserted-by":"crossref","first-page":"268","DOI":"10.3171\/jns.1981.54.2.0268","article-title":"Preservation of facial and acoustic nerves in total removal of large and small acoustic tumors. 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