Middle fossa decompression of the internal auditory canal in acoustic neuroma surgery: A therapeutic alternative

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Abstract
Unilateral acoustic neuromas in only‐hearing ears and bilateral acoustic neuromas (NF‐2) are separate entities, but both pose a common problem because surgical removal has the potential to leave the patient totally deafened.A middle fossa decompression of the internal auditory canal (IAC) was performed in 8 patients (5 with NF‐2 tumors and 3 with neuromas in an only‐hearing ear). In 5 of the 8, the speech discrimination scores at the 6‐month follow‐up were better than preoperative scores. After 6 months, however, hearing regressed at variable rates. Although not a definitive therapeutic treatment, decompression of the IAC appears to improve and perhaps prolong useful hearing, which gains valuable time for rehabilitation. Rigid follow‐up by computed tomography scans or magnetic resonance imaging is essential.