Abstract:ObjectiveTo investigate the management methods and outcomes of the jugular bulb (JB) during acoustic neuroma (AN) surgery via translabyrinthine approach.MethodsClinical data, including management methods and results of the JB, of 72 patients with AN surgically treated via translabyrinthine approach by the same surgeon between Jan. 2016 and June 2017 in our department were analyzed retrospectively.ResultsOf all 72 cases, the incidence of high jugular bulb (HJB) was 29.2% (21 cases). The exposure of JB was satisfactory in all the cases. During lowering the JB to expose the inferior compartment of cerebellopontine angle (CPA) in 50 cases, intraoperative rupture of the JB occurred in 4 cases with HJB. For hemostasis, Surgicels was packed in the ruptured JB in 3 patients, and one was treated with bipolar coagulation. The maximal diameter of the AN was (2.4±1.5) cm. Total resection of AN was achieved in 70 patients, and subtotal resection in 2. Facial nerve was preserved both anatomically and functionally with normal function of the posterior cranial nerves in all the 72 cases. Oneyear followup revealed no tumor recurrence in magnetic resonance imaging (MRI) examination in all cases, and facial nerve function of HouseBrackmann (HB) grade I or II in 66 cases (91.7%) as well as HB grade III or IV in 6(8.3%).ConclusionProper management of JB during AN surgery via translabyrinthine approach provides adequate exposure of CPA with simultaneous reduction of risks of JB rupture and posterior cranial nerves injury.
