Craniotomy procedure for acoustic neuroma

The surgical procedure for craniotomy in acoustic neuroma involves making a small incision within the hairline, followed by gradual cutting through the skin and skull to locate and remove the tumor. This operation must be performed at a正规 hospital. The specific steps are as follows:

1. Before surgery, imaging studies are used to clearly define the tumor's location and extent, based on which the appropriate craniotomy approach is selected.

2. The patient enters the operating room and is placed in a lateral position. General anesthesia is administered by an anesthesiologist, while the surgeon routinely disinfects the scalp, skin around the ear, cheek, and neck-occipital area.

3. After anesthesia takes effect, the surgeon makes an incision using the retrosigmoid suboccipital approach behind the patient’s ear. The incision starts above the attachment line of the auricle, extends backward 4–5 cm, then turns downward and continues approximately 2 cm behind the mastoid tip, ending 1–2 cm below the level of the mastoid tip.

4. Three small burr holes are drilled at the incision site. These holes are connected to open the skull bone. The dura mater is then incised, and access is gained into the cerebellopontine cistern beneath. Cerebrospinal fluid is released to reduce intracranial pressure, after which the tumor is further exposed by dissecting along the cerebellopontine angle cistern.

5. Partial removal of the tumor is first performed internally. Then, careful dissection separates the tumor from surrounding nerves and blood vessels. The interface between the tumor and adjacent neural structures is precisely identified, and the tumor is peeled away from the nerve. The intrameatal portion within the internal auditory canal is subsequently exposed and resected.

6. The dura mater is sutured closed, the bone flap is replaced and fixed, and the muscle, subcutaneous tissue, and skin are sutured layer by layer. The surgery concludes with wound closure.

After surgery, patients should follow medical staff instructions and avoid making independent decisions. If facial paralysis occurs postoperatively, prompt measures should be taken to protect the cornea.