Osteoplastic lateral suboccipital approach for acoustic neuroma surgery.

Abstract

Persistent headache remains a significant problem in a small group of patients after acoustic neuroma surgery via the lateral suboccipital approach. We describe a modified technique of osteoplastic lateral suboccipital craniotomy for surgery of the cerebellopontine angle. This simple and elegant technique provides a superior cosmetic result and a significant reduction in patients' symptoms. We report on our series of 75 patients who underwent surgery for acoustic neuroma. The maximal follow-up period was 4 years. No patients reported headache postoperatively. Cerebrospinal fluid fistulae were not observed. This modified approach minimizes cerebellar retraction, and the neural and vascular structures can be preserved under direct visualization of the tumor. This lateral suboccipital approach is a useful modification of previous approaches in acoustic neuroma surgery. It provides successful tumor resection and excellent functional results.