Facial function in hearing preservation acoustic neuroma surgery.

OBJECTIVE To determine if facial function is worse after hearing preservation acoustic neuroma surgery (retrosigmoid and middle fossa) than in translabyrinthine surgery. DESIGN Retrospective medical record review. SETTING Private neuro-otology subspecialty practice of patients operated on in a tertiary care hospital. PATIENTS This study evaluated 315 consecutive acoustic neuroma surgical procedures between April 1989 and July 1998. A total of 209 translabyrinthine procedures and 106 hearing preservation surgical procedures were performed. The hearing preservation procedures were equally divided between retrosigmoid (n = 48) and middle fossa (n = 58) procedures. METHODS Medical records were reviewed and tabulated for tumor size, surgical approach, and House-Brackmann facial function grade at short-, intermediate-, and long-term intervals. RESULTS Postoperative facial function in hearing preservation surgical procedures at short- and long-term follow-up was not worse than facial function after translabyrinthine surgical procedures in comparably sized tumors. CONCLUSION Concern about postoperative facial function should not be the deciding factor in selecting hearing preservation vs nonhearing preservation acoustic neuroma surgery.