Microsurgical Anatomy of Acoustic Neuroma

This article reviews the microsurgical anatomy important to preserving the involved cranial nerves and adjacent neural and vascular structures during acoustic neuroma removal. These anatomic considerations are divided into sections dealing with the relationships at the lateral end of the tumor in the meatus and those on the medial end of the tumor at the brain stem. The anatomy of the region offers the opportunity for three approaches to the tumor in the meatus and cerebellopontine angle. One is directed through the middle cranial fossa and the roof of the meatus. Another is directed throught the labyrinth and posterior surface of the temporal bone. The third is directed through the posterior cranial fossa and posterior meatel lip. The anatomy presented by all three approaches is reviewed in this article.