Preservation of hearing in bilateral acoustic neurinomas by deliberate partial resection.

With the aim of preserving hearing, 20 acoustic neurinomas in 17 patients with neurofibromatosis 2 were intentionally submitted to an incomplete (80%) tumour removal. In 12 cases this was an operation on the last hearing ear with total deafness of the contralateral ear. If an auditus existed in both ears the better hearing ear was selected for the primary intervention.

[Transcranial magnetic stimulation of the facial nerve in patients with acoustic neuroma].

Magnetic stimulation of the human facial nerve was used in 30 patients with small or medium-sized acoustic neurinomas pre-operatively. Needle-EMG revealed symmetrical aspect in the orbicularis oris muscle on the affected and on the contralateral side. The latencies in the extracranial part of the facial nerve after supramaximal electric stimulation in the area of the stylomastoid foramen and the latencies after temporo-occipital, transcranial magnetic stimulation were measured.

New markers for the neurofibromatosis-2 region generated by microdissection of chromosome 22.

To identify new DNA markers around the neurofibromatosis-2 gene on human chromosome 22, the critical region (22q12-q13.1) was microdissected and microcloned from GTG-banded metaphase chromosomes. Eighteen thousand recombinant clones were obtained.

Extended middle cranial fossa approach for acoustic neuroma surgery.

The enlarged middle cranial fossa approach was used for removal of acoustic neuromas in 209 cases. Complete tumor removal was accomplished in 96% of cases. Hearing was preserved in 51% of cases, with better results in smaller tumors.

Topographical anatomy of the internal auditory canal. Implications for functional surgery in the cerebello-pontine angle.

For exposure of the cerebello-pontine angle by an enlarged middle-fossa approach without destruction of the inner ear, bone removal anterior and posterior to the internal auditory meatus (c.a.i.

Posture and central compensation after acoustic neurinoma surgery.

After acoustic neurinoma surgery via the enlarged middle cranial fossa approach the patients usually benefit from a good prognosis of the vestibular compensation, almost independent of the size of the tumour and of the patient's age, if the central vestibular pathways were not injured. Only 8% of the patients showed a reduced vestibular compensation. The success and gradation of the vestibular compensation in diseases with a permanent labyrinthine loss, even though after acoustic neurinoma surgery, can easily be classified by the so-called vestibular-index.

[Diagnostic and treatment of lesions of the facial nerve after fractures of the temporal bone].

The authors review functional late results of 47 cases of facial palsies due to otobasal fracture by considering the clinical and electrophysiological test results, seen between 1983 and 1988. There were 36 longitudinal, 5 transversal and 6 combined temporal bone fractures. 5 patients suffered from a bilateral facial paralysis.

Transtemporal planned partial resection of bilateral acoustic neurinomas.

In an attempt to overcome the complete auditory deprivation of young patients with bilateral acoustic nerve schwannomas (Morbus v. Recklinghausen) a planned partial resection of the tumour was carried out in 11 hearing ears. The cerebello-pontine angle was exposed by the enlarged middle fossa approach (Wigand et al.

[Gastric microhemorrhage and acetylsalicylic acid. Prevention using prostaglandin E2].

The possible prophylactic effect of prostaglandin E2 (PGE2) pretreatment against gastric microbleedings caused by acetylsalicylic acid was investigated in six healthy volunteers. Gastric microbleeding rate was determined by the gastric tube technique of Fisher and Hunt, at first without any medication. The test was repeated after a two-day intake of acetylsalicylic acid (four times 0.