ACOUSTIC NEUROMA SURGERY
Dr. Hrayr Shahinian: Endoscopic Acoustic Neuroma Surgery. Through a minimally invasive dime-size opening behind the ear, a 2.7-millimeter endoscope is introduced into the posterior fossa and slowly advanced to the cerebellopontine angle. A grade three 2-1/2 x 3-centimeter acoustic neuroma is visualized. After electro-coagulating its surface, the central portion of the tumor is cored out and the tumor is decompressed. The capsule of the tumor is visualized and is dissected off of the surrounding structures, including the brain stem and other cranial nerves.Â Using micro-dissection techniques, the capsule is dissected off of the facial nerve and is resected. A complete resection of the tumor is, thus, achieved. The tumor bed is visualized, free of tumor. The opening is reconstructed using a micro-plate, incision is closed. The procedure is performed through a minimally invasive dime-size opening through a 2.7-millimeter endoscope. The patient is observed overnight in the surgical intensive care unit and is discharged home in 48 hours with no major neurologic deficit.