A suboccipital craniotomy is a surgery performed to remove an acoustic neuroma growing from the nerve responsible for balance and hearing. During surgery, a section of the skull is removed behind the ear to access the tumor and nerves. Acoustic neuromas cause hearing loss, ringing in the ears, and dizziness. The goals of surgery are: first, maintaining facial nerve function; second, preserving socially useful hearing in the affected ear; and third, removing the tumor.
What is suboccipital acoustic neuroma surgery?
A craniotomy is any bony opening cut into the skull. The section of skull, called a bone flap, is removed to access the brain underneath. After the tumor is removed, the bone flap is placed back in its original position and secured with plates and screws.
An acoustic neuroma may be surgically removed by one of three different craniotomies: suboccipital, translabyrinthine, or middle fossa. The choice of a particular craniotomy depends on the tumor size, tumor position, and hearing status. The suboccipital craniotomy (also called retrosigmoid) involves removing a portion of the occipital bone behind the ear to remove the tumor
Who is the candidate?
You may be a candidate for suboccipital acoustic neuroma surgery if you have:
- A medium or large acoustic neuroma that is causing symptoms, especially balance problems caused by brainstem compression
- Serviceable hearing in the affected ear
- Neurofibromatosis type 2 (NF-2)
Who performs the surgery?
A neurosurgeon or neuro-otologist can remove acoustic neuromas. The suboccipital approach is performed by a neurosurgeon. Because each patient and each acoustic neuroma is unique, it is important to seek treatment at a center that offers the full range of options, including surgery, radiation, and hearing rehabilitation.
Preventing or treating deafness in both ears for people with NF-2 requires a team approach. Studies show that tumor size and the surgeon’s experience are the most significant factors influencing facial nerve function and hearing outcome after removal .
What happens before surgery?
You will have an office visit with a neurosurgeon, otologic surgeon, and an audiologist before surgery. An audiologist will perform a hearing test and a presurgical assessment of cranial nerve function. During the office visit, the surgeon will explain the procedure, its risks and benefits, and answer any questions.
Next, you will sign consent forms and complete paperwork to inform the surgeon about your medical history (i.e., allergies, medicines, vitamins, bleeding history, anesthesia reactions, prior surgeries). Discuss all medications (prescription, over-the-counter, and herbal supplements) you are taking with your healthcare provider. Some medications will need to be continued or stopped the day of surgery. You will be scheduled for presurgical tests (e.g., a blood test, electrocardiogram, chest X-ray, and CT scan) several days before surgery.
Stop taking all non-steroidal anti-inflammatory medicines (Naprosyn, Advil, Motrin, Nuprin, Aleve) and blood thinners (coumadin, Plavix, aspirin) 1 week before surgery. Additionally, stop smoking and chewing tobacco 1 week before and 2 weeks after surgery, as these activities can cause bleeding problems. Wash your hair with Hibiclens® (chlorhexidine) antiseptic soap for 3 consecutive days prior to surgery. No food or drink is permitted past midnight the night before surgery.
Morning of surgery
- Shower using antibacterial soap. Dress in freshly washed, loose-fitting clothing.
- Wear flat-heeled shoes with closed backs.
- If you have instructions to take regular medication the morning of surgery, do so with small sips of water.
- Remove make-up, hairpins, contacts, body piercings, nail polish, etc.
- Leave all valuables and jewelry at home (including wedding bands).
- Bring a list of medications (prescriptions, over-the-counter, and herbal supplements) with dosages and the times of day usually taken.
- Bring a list of allergies to medication or foods.
Arrive at the hospital 2 hours before your scheduled surgery time to complete the necessary paperwork and pre-procedure work-ups. You will meet with a nurse who will ask your name, date of birth, and what procedure you are having. The nurse will explain the preoperative process and discuss any questions you may have. An anesthesiologist will talk with you to explain the effects of anesthesia and its risks. An intravenous (IV) line will be placed in your arm before transport to the operating room.
What happens after surgery?
After surgery, you are taken to the recovery room where vital signs are monitored as you awake from anesthesia. You may have a sore throat from the tube used to assist your breathing. After you awaken, you’ll be moved to the neuroscience intensive care unit (NSICU) for close monitoring. Your blood pressure, heart rate, and respiration will be monitored. You may experience nausea, unsteadiness, and headache after surgery. Medication can control these symptoms. When your condition stabilizes, you will be transferred to a regular room, where you will begin to increase your activity level.
How To Reach Us?
Dr. Suraj Giri is a trusted ENT Specialist in PCMC, Pune. He has made many happy patients in his 12 years of journey as a ENT Specialist. At Devgiri Memorial Hospital you will get all the necessary medical treatment. Our advanced approach for our patient treatments make us unique.
The appointment process at Devgiri Memorial Hospital PCMC Pune is very simple. You can directly call on 09657002695. Also with the help of the “Book an Appointment” Form you can book your appointment by just filling in the basic information. We will contact you via email or phone call to confirm your appointment.
