[Complete excision of XXXX . Preservation of the facial nerve and hearing].

@entity1 @entity5513 @entity944 @entity2103 @entity1576 @entity393 @entity2950
Using microtechniques, total removal of @entity5513 with @entity2103 is possible today in most cases. The next barrier of operative treatment is hearing preservation which is routinely attempted, with the help of intraoperative brainstem auditory evoked responses monitoring. The present series deals with 176 operations performed sub-occipitally in 159 @entity1 from 1970 up to 1985. Twelve @entity1 were operated upon 29 times. According to the W.T. Koos classification, there were 16 type II, 39 type III and 121 type IV @entity2950 . Ten @entity1 died postoperatively. In seven of these, death was related to surgery, in two it was caused by @entity1576 . In the last @entity1 unexplained @entity944 occurred. 169 @entity1 had no facial weakness preoperatively, in 158 of these the facial nerve was anatomically preserved (93.5%). @entity2103 was judged by evaluation of function of face at least 12 months after operation. Up to 36 months after surgery, a good facial result may be expected in cases where the facial nerve was macroscopically spared at completion of removal. Functional results have been reviewed in 151 @entity1 according to the J.W. House's International Evaluation System, with an excellent or good result in 66 (44%), fair in 65 (43%), bad or poor in 20 (13%). The anatomical preservation of the cochlear nerve could be achieved in 80 @entity1 of the group of 169 in whom the auditory function had not been damaged by a previous operation. In fact, the auditory function preservation could be reasonably attempted in 79 @entity1 : showing a @entity393 below 70 dB on tone audiometry, whatever may be the result of speech discrimination score. 59 @entity1 (75%) of this later group had their auditory nerve preserved, 14 (18%) showed preserved hearing function postoperatively, 10 of these with a speech discrimination score over 50%. Two of these showed an improvement of preoperative hearing, two others showed a total recovery of hearing function after removal.
