Cerebellar vessels were cauterized with bipolar and the ultrasonic dissector/aspirator was used to remove the lateral portion of the right cerebellar lobe in order to expose the tumor. This resection causes no appreciable deficit in balance and equilibrium.
The dissecting microscope was moved into place. The dome of the tumor is seen at the bottom of the cavity. The tumor was progressively dissected from the inside out, leaving a rind which could be peeled out. Because of space constraints, it is not possible to resect an intact tumor. Some acoustic neuromas have a liquid center early in their course, making them easier to aspirate and resect. Longer standing tumors may become fibrotic. No attempt was made to drill out the canal in this case to remove the residual cannilicular portion because the associated morbidity outweighed the possible benefit. The plan was to observe and possibly treat the cannilicular portion with the gamma knife if warranted. The patient had a partial hearing loss on the right, which was expected to improve.
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