Complications of the Translabyrinthine Approach for the Removal of Acoustic Neuromas

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Abstract
SINCE ITS INTRODUCTION in the 1960s,1 the translabyrinthine approach (TLA) has become an increasingly popular method of excising acoustic neuromas. Advantages of this approach include a low complication rate, particularly with regard to facial nerve function,2 and total tumor removal in the vast majority of cases.2,3 Moreover, it is safe and effective, even with the largest of tumors.4,5 These considerations have made the TLA the procedure of choice for most neuro-otologists in the treatment of patients with nonserviceable hearing. More controversy exists, however, in the treatment of patients with serviceable or "borderline" hearing. Procedures that attempt to preserve hearing in such patients involve different risks, particularly with regard to intracranial and facial nerve complications. These different risks must be weighed against risks of translabyrinthine surgery before a decision can be made as to whether an attempt at hearing preservation is prudent.