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Acoustic Neuroma and Skull Base Surgery

edited by: J.M. Sterkers & R. Charachon & O. Sterkers & G. O'Donnoghue & J. Fenton

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Publication details: Book. 1996. xiv and 754 pages. Publication date: 1996-08-30. 347 figures and 203 tables. Hardbound.

ISBN: 978-90-6299-128-0 (ISBN 10: 90-6299-128-9; Kugler Publications)



For me, the collaboration between neurosurgeons and ENT surgeons was spontaneous. By the time I was a senior resident, I felt very strongly that I should entrust patients with brain abscesses to one of my neurosurgical colleagues. Later on, these colleagues asked me to help them with the removal of hypophysis tumors via the transseptal approach, and then with finding the facial nerve in the internal auditory canal when using a suboccipital approach to remove an acoustic neuroma.
At the same time, in 1965, 1 was among the happy few who visited Bill House after having seen the schematic drawing of his middle fossa approach. I saw him working in a team with William Hitselberger, and I was fascinated by his vision. As ENT surgeons, when we daily perform middle ear surgery, we know how to deal with the upper cervical region and how to drill through the very complicated temporal bone, preserving the facial nerve and inner ear function. This is why we are so involved with preserving the facial nerve in skull base surgery as well. We need to be taught how to deal with the soft tissues of the posterior and middle fossa by neurosurgeons. We ENT surgeons are also deeply involved in surgery of the paranasal sinuses and their surroundings. Since the time we began to work in a team with neurosurgeons, we have also been making progress in tumor surgery. There are, of course, many other examples. This is the reason for the recent foundation of international, European and national skull base societies, which have met with great success. These societies show why it is necessary to join forces between several specialties (neurosurgery, ENT, neuroradiology, maxillofacial surgery, and radiotherapy) in order to improve the results in our patients. At this joint meeting, we have tried our best to bring together the most qualified specialists in order to discuss the state-of-the-art in those fields, which are developing the fastest. We hope that we have been at least partially successful in this. We also hope that this book will provide food for thought with regard to the progress of our common discipline, the skull base.

R. Charachon



I realize that it is a great honor to have been chosen as the President of the Second International Conference on Acoustic Neuroma Firstly, I must thank you all for coming to this Second International Conference on Acoustic Neuroma. Many of you have had to travel long distances to get to Paris, and I want particularly to express my thanks to Professor Tato and all my colleagues and friends who have honored us with their presence. When the first monogram by Bill House appeared in 1964, I was visiting John Shea in Memphis, Tennessee, and he advocated that I should travel to Los Angeles. Since then I have been deeply involved with this fascinating surgery. I have operated on more than 1600 cases, which implies a great number of hours spent in the 'bloody' comer. A current theory on the development of language in primates suggests that the dexterity of the hands of our forerunners promoted cerebral development and, as a consequence, language appeared and homo sapiens emerged. Microsurgery in the management of acoustic neuroma has certainly developed our manual skills and, as we will discover during this conference, our intellectual concept of this disease process and the eloquence of our discussion on the controversies surrounding its treatment. It is still interesting to analyze the advent of this subspeciality. A new instrument, the Zeiss operating microscope, and a new man from a specialty other than the traditional one, it was William House who created oto-neurosurgery for the removal of acoustic tumors with the help of this new instrument. Prior to that, and specifically in France during the 1930s, my ENT masters, Maurice Aubry and Marcel Ombredanne, had utilized the posterior fossa approach to section the vestibular nerve. They reported a small acoustic neuroma in two cases thought previously to have menieres disease, and proposed that the optimal time to excise these tumors would be when they were small. Later on, another of my masters, Pierre Clerc, described the middle fossa approach in the treatment of facial palsy of the labyrinthine segment and in 1953 he predicted that the internal auditory meatus could be reached via this approach.
It was Bill House who performed the first 'conventional' approach to the internal auditory meatus. So, why was Bill House the first to invent oto-neurosurgery? I think that the reasons are multiple: he was and still is fundamentally interested in revolving unsolved problems; he was also in the best environment to come up with new ideas and new concepts, and to develop new treatments if the classical ones were not successful. This was the case in the operative management of acoustic neuroma at that time. This 'best environment' was created by his half-brother Howard House who always encouraged those with new ideas. The background of medical publications, the constant pursuit of surgical excellence (which he compared to the learning process of sportsmen), the reflection, analysis and knowledge acquired from malexperiences, and a broad-based interest in clinical research: all these intellectual and manual qualities, and also the assistance of his wife June and of his colleagues including the unconventional neurosurgeon W. Hitselberger, help to explain the originality of his work. Since then, a rivalry has evolved between the oto-neurosurgeon and the neurosurgeon and we now have a paradoxical situation whereby neurosurgeons defend hearing function while otoneurosurgeons accord priority to facial nerve function in line with their conception of human psychology. But, in fact, a description that is more appropriate than rivalry is emulation, which is the true situation that has appeared between our two specialities - emulation is a better philosophy than rivalry as it means that one should admit to the superiority of the other if his results are better than yours. Acoustic neuroma surgery is a situation that one can conquer by oneself, but also on( should respect the other if he is not as successful, and one should offer to collaborate. In the early days, the surgical indications were simple. All tumors were excised. Nowadays the situation has changed with the introduction of MRI and the perfection of surgical methods, The operative indications and the choice of approach are more complex. Questions persist and new queries continue to arise in acoustic neuroma management, for example: 1. Is there a greater risk of recurrence when preserving the cochlear nerve? 2. Is it possible, at present, to predict or eliminate the subsequent occurrence of an acoustic neuroma on the contralateral side? 3. Is there still an indication for operating on intracanalicular tumors without a period of observation? Hopefully we can make progress in solving these dilemmas during this conference. The qualities of the faculty, the great number of free papers, videos and posters, will hopefully ensure that this Second Conference on Acoustic Neuroma will be as successful as the first one, which was organized in 1991 by my friends Mirko Tos and Jens Thomsen in Copenhagen. I cannot conclude without expressing my gratitude to my friend and colleague Robert Charachon and the European Skull Base Society which has agreed to link its Congress with our Conference. I would also like to thank Olivier Sterkers for organizing and coordinating both components of this meeting. I cannot finish without remembering with great sorrow my deeply regretted wife, Dr. Nicole Sterkers, who from the first day to her last encouraged and supported me in my work in this new field, no matter which difficulties arose. I now declare the Second Conference on Acoustic Neuroma officially open and relinquish my place on the podium to Robert Charachon.

Jean-Marc Sterkers 

Table of Contents

Table of Contents



Acoustic neuroma - past, present and future
M. Portmann

Annandale's case, a hundred years on. 'A brilliant surgical result, the first recorded'
R. T. Ramsden


Cytophotometric characteristics, histology and proliferation markers in acoustic neuromas
J. Maurer, H.-J. Welkoborsky and W.J. Mann

Immunohistochernical determination of the growth fraction in vestibular schwannoma
S. Charabi, P. Engel, B. Charabi, G.K. Jacobsen, J. Thomsen and M. Tos

In vivo growth model for vestibular schwannoma
S. Charabi, J. Rygaard, K. Simonsen, B. Charabi, M. Tos, J. Thomsen and G.K. Jacobsen

Molecular genetic analysis of patients with neurofibromatosis 2 and sporadic meningiomas
N. Monnier, E. Lerouge, H. Zhao, P. Lescuyer, L. Azoti, J-P. Lavieille, R. Charachon and J. Lunardi

Acoustic neuromas: evolutive factors
Ch. Martin, L. Chelikh, J.M. Prades, R. Duthel and J.M. Dumollard

Nerve origin of acoustic neuromas
A. Komatsuzaki and A. Tsunoda

Pathological features of the VIIIth cranial nerve adjacent to acoustic neuromas
T. Matsunaga and J. Kanzaki


3-D imaging for skull base surgery
M.J. Gleeson, D.L. Hill, D.J. Hawkes, T.C. Cox, C. Ruff, C. Studholme, A. Gandhe,
J. Zhao, A. Colchester and A. Strong

MRI in the detection of acoustic neuroma: a suggested protocol for screening
I.J. Sheppard, C.A. Mitford and P. Anslow

MRI and high resolution CT scan in acoustic neuromas: which is the best surgical plan?
R. Ferreira Bento, A. Miniti and T. Ganz Sanchez

Magnetic resonance imaging following vestibular schwannoma excision
D.A. Moffat, P.D. Phelps and D.G. Hardy


Normal hearing in acoustic neuroma: is it really atypical?
M. Falcioni, G. De Donato, E. Saleh, A. Taibah, A. Russo and M. Sanna

Clinical tests of vestibular function in vestibular schwannoma: correlation with size
G.J. Beynon, D.M. Baguley and D.A. Moffat

Sonomotor vestibular response to contralateral stimulation in acoustic neuroma
C. Ferber-Viart, B. Colleaux, C. Dubreuil and R. Duclaux


Influence of temperature, pressure and blood supply on cochlear nerve function
V. Braun and H-P. Richter

Intraoperative monitoring of cranial nerves
A.R. Møller

Intraoperative monitoring of cranial nerves
H.-J. Welkoborsky, J. Maurer, H. Pelster and W.J. Mann

The use of the NIM-2 monitor as a predictor of normal facial nerve function immediately post-cerebellopontine angle tumor surgery
J.E. Fenton, A. Shirazi, M.D. Atlas and P.A. Fagan

The value of facial nerve monitoring in acoustic tumor surgery
R.M. Walsh, J.P. Pracy, M.J. Gleeson and A. Strong

Facial nerve preservation in acoustic neuroma surgery with stimulus microinstruments:
extended middle cranial fossa approach
J. Kanzaki, R. Shiobara, K. 0gawa, Y. Inoue, Y. Satoh, S. Yoshihara and S. Toya

The effect of nerve monitoring on facial nerve outcome in acoustic neuroma surgery
P.L. Grey, D.A. Moffat, D.G. Hardy, D.M. Baguley and C.R. Palmer

Intraoperative EMG facial nerve monitoring in cerebellopontine angle tumors: prognostic value of 'train' activity
A. Rinaldi Ceroni, G.C. Hodugno, G.G. Ferri, A. Trogu, A. Fioravanti and F. Calbucci


Two illuminating instruments for acoustic neurinoma surgery
Y. Tanaka, S. Kobayashi, H. Gibo and T. Iwashita

KTP YAG laser in acoustic neuroma surgery
C. Dubreuil, B. Colleaux and B. Boulud

Endoscopic guided microsurgery of the internal auditory canal in acoustic neuroma surgery
C. Dubreuil, B. Colleaux and B. Boulud


The surgical anatomy of the cerebellopontine space
M. Gersdorff and M. Decat

Acoustic neuroma surgery: 100 recent cases
J.M. Sterkers, J.E. Fenton and M. Smail

Cystic acoustic neuroma: neuroradiology, histopathology and surgical results
M. Tos, S. Charabi, J. Thomsen, M. Mantoni, L. Klinken, B. Charabi and S.E. Børgesen

Intralabyrinthine schwannomas
R. Kuhweide, J.W. Casselman and W. Ampe

Recurrent acoustic neuromas: clinical and pathological characteristics
T. Sano, Y Seki, T Aiba, A. Teramoto and S. Takemori

Management of acoustic neuroma through the enlarged translabyrinthine approach: how can
we improve the results?
F. Mancini, M. Falcioni, M. Landolfi, A. Taibah, A. Russo, A. Mazzoni and M. Sanna

Experience in 115 cases of acoustic neuroma surgery
R.F. Bento, A. Miniti and P. Bogar

Hydroxyapatite cement reconstruction of craniectomy defects after translabyrinthine removal of acoustic neuroma
J.F. Kveton and C.D. Friedman


Intracanalicular acoustic neuromas
J.M. Sterkers, J.E. Fenton and M. Smail

Significance of hearing restoration in the surgery of small acoustic tumors
N. Yanagihara. S. Murakami, T. Hatakeyania and K. Zenke

Management of small acoustic neurinomas
R. Charachon, J.P. Chirossel and J.-P. Lavieille

Functional results in small acoustic neuroma surgery
A. Robier, E. Lescanne, M. Tossou, M. Jan and P. Beutter


Three-dimensional CT reconstruction for the middle cranial fossa approach in early acoustic neuroma surgery
A. Tsunoda, A. Koniatsuzaki and H. Muraoka

Classification of hearing results after resection of acoustic neuromas: extended middle cranial fossa approach
J. Kanzaki, R. Shiobara, K. Ogawa, Y. Inoue, Y. Satoh, S. Yoshihara and S. Toya

Indications and technique for, and advantages of the enlarged middle fossa approach
M.E. Wigand, C.-T Haid, M. Berg and S.R. Wolf

Function-preserving surgery of acoustic neurinomas via the enlarged middle cranial fossa approach
C.-T Haid, M.E. Wigand, S.R. Wolf and M. Berg

Hearing preservation following the enlarged middle fossa approach for vestibular
schwannoma removal
A. Russo, S. Karmarkar, E. Saleh, A. Taibah, F. Mancini and M. Sanna

Extended middle cranial fossa approach for acoustic neuroma
R. Shiobara, T. Ohira, T. Kawase, J. Kanzaki and S. Toya

Experience of 29 cases of acoustic neuroma surgery by the middle cranial fossa approach
K. Ishikawa, N. Yasui, K. Mineura, K. Monoh, H. Sasajima and K. Togawa

Workshop: New instrumentation in skull base surgery
A. Komatsuzaki and A. Tsunoda

The long-term outcome of hearing preservation following acoustic neuroma surgery
Y. Inoue, K. Ogawa and J. Kanzaki


Monoaural auditory performance index: a method to report hearing results in functional
acoustic neuroma surgery
V. Calabrese, D. Cuda and A. Mazzoni

Direct approach to the lateral end of the internal auditory canal through a retrosigmoid
approach: development of the technique and results in acoustic neuroma surgery
G. Danesi, A. Mazzoni, V. Calabrese and A. Poletti

A safe landmark for labyrinthine preservation in acoustic neurinoma surgery
R.L. Silveira, F.A.P. Ferraz, S. Gusmaô and G. Cabral

Different prognostic factors for hearing preservation in surgery for acoustic neuroma in women and men
B. Schaller, R. Probst, O. Gratzl, J.A. Rem and R. Hauser

Acoustic neuroma predicting data for hearing preservation
C. Dubreuil, B. Colleaux, B. Boulud and C. Ferber

Follow-up results of preserved hearing after radical removal of acoustic neuromas
T. Sano, Y. Seki, H. Umezu, T. Aiba, A. Teramoto and S. Takemori

Hearing preservation in the surgical removal of cerebellopontine angle tumors: value of ABR monitoring
G.C. Hodugno, A. Rinaldi Ceroni, G.G. Ferri, A. Trogu, A. Fioravanti and F. Calbucci

Combined treatment of acoustic neuromas in Wuerzburg: surgery and monitoring
W. Dittmann, M. Janka, H.P. Schlake, J. Helms and K. Roosen

Surgical treatment of acoustic neuromas: prognostic factors in the preservation of facial nerve function
E.A.S. Vellutini

Late functional results of acoustic neuroma surgery by the retrosigmoid approach
S. Giombini, F. Pluchino, G. Cella, M.G. Pluchino and M. Fornari

Hearing preservation in medial acoustic neuromas
J.E. Fenton, M. Kalamarides, D. Bouccara, P. Henrion, R. Matheron, A. Rev and
O. Sterkers


An alternative to surgery in acoustic neuroma management: is no treatment good treatment?
J. Thomsen, S. Charabi, M. Tos, M. Mantoni and B. Charabi

Acoustic neuroma: observation, surgery or Gamma-knife treatment
P. Møller, E. Myrseth, ø. Jensen, P.H. Pedersen, J.L. Larsen, J. Kråkenes, G. Moen and
A.I. Smievold

Natural growth of acoustic neuromas in older patients
Ch. Martin, O. Deguine, B. Fraysse, L. Chelikh and M.V. Cadene

Does age-dependent management of acoustic neurinomas exist?
M.E. Wigand, S.R. Wolf and B. Eichhorn

Management of acoustic neuromas according to age
A. Rey, O. Sterkers, M. Kalamarides, D. Bouccara and R. Matheron


Clinical features of neurofibromatosis in patients with unilateral vestibular schwannomas
W.J. Neary, V.E. Newton, S.N. Laoide-Kemp, R.T. Ramsden, G. Griffith, D.G. Evans and
R. Harris

Bilateral acoustic neurinoma: what is the best operative management?
D. Tenckhoff, F Soldner, S. Al-Hand and T. Wallenfang

The role of auditory implants in acoustic neuroma surgery
J.E. Fenton, M.D. Atlas and P.A. Fagan

Surgical experiences in multichannel stimulation of the cochlear nucleus
W.-P. Sollmann and R. Laszig

Cochlear implantation following tumor removal in a bilateral acoustic neuroma deafened patient
T. Tono, Y. Ushisako and T Morimitsu


Interobserver variability in the assessment of facial function
R.H. Lye, S. Chatterjee and R.T. Ramsden

Interchange table between House-Brackmann's system and Yanagihara's system
Y. Satoh, J. Kanzaki, T. O-Uchi, S. Yoshihara, T. Ohira and Y. Inoue

Recovery process and functional prognosis of the facial nerve following acoustic tumor surgery
T. Yokoyama, K. Uemura, H. Ryu, K. Hinokuma, S. Nisizawa, S. Yamamoto and M. Endo

Can the long-term prognosis of facial nerve function be anticipated from the ENoG and
EMG findings in the early stages after acoustic neuroma removal?
S. Yoshihara, J. Kanzaki, T. O-Uchi, Y. Satoh, T. Ohira and Y. Inoue

Intraoperative and delayed repair of facial function
J.-M. Thomassin, M. Cannoni, M. Zonaret and W. Pellet

Rehabilitation of facial nerve palsy after surgery for acoustic neuroma
E. Dalla Toffola, L. Petrucci, S. Ricotti, G. Carenzio and A. Ruju


A study of perioperative lumbar CSF pressure in patients undergoing acoustic neuroma surgery
D. Hardy, P. Smielewski, M. Czosnyka, R. Laing and J. Pickard

Prevention of cerebrospinal fluid rhinorrhea in translabyrinthine surgery for vestibular schwannomas
H. Lacombe, Y. Keravel and F. Nigri

Headache following acoustic neuroma removal
S.G. Harner, C.W. Beatty and M.J Ebersold

Postoperative pain after surgery for acoustic neurinoma
H. Levo, I.V. Pyykkö and G.C. Blomstedt

Depression, a common complication after acoustic neuroma surgery
G.C. Blomstedt, H. Katila, M. Henriksson, A. Ekholm, J.E. Jddskeldinen and I.V. Pyykkö


Audio-vestibular findings in cerebellopontine angle meningioma
D.M. Baguley, G.J. Beynon, P.L. Grey, D.G. Hardy and D.A. Moffat

Experiences and results of postero-inferior re-routing of the facial nerve in 13 consecutive
patients operated on for petroclival meningiomas
A. Kinnefors, L. Ekvall, G. Nyberg and H. Rask-Andersen

Petroclival meningiomas: our surgical experience with different approaches
S. Paterniti, A. Musolino, P. Fiore, A. La Camera and S. Cambria

Combined supra- and infratentorial approach for tentorial notch meningiomas
P. Sloniewski, J. Morys and P. Zielinski

Meningiomas involving the cavernous sinus: critical analysis based on our experience with 16 cases treated surgically
G.P. Tassi, R.J. Galzio, D. Lucantoni, V. Magliani and A. Ricci

Meingiomas and neurinomas of the foramen magnum region
W.-P. Sollmann

Management of jugular foramen meningioma with or without neck extension to the jugulo-carotid space
A. Taibah, E. Saleh, V. Achilli, A. Russo, A. Mazzoni and M. Sanna


The role of the lower cranial nerves in jugular foramen surgery
J.E. Fenton, H. Brake, A. Shirazi, M.S. Mendelsohn, M.D. Atlas and P.A. Fagan

Glomus jugulare tumors in Finland
T.S. Karhuketo, H.J. Puhakka, I.V. Pyykkö, J.T.K. Suonpaä, K.T. Laitakari and J.S. Ylikoski

Combined approach function-oriented surgery for glomus jugulare tumors
M. Gjuric, M.E. Wigand, C.-T. Haid and M. Weidenbecher

The surgical management of glomus tumors of the temporal bone
E. Truy, A. Morgon and C. Dubreuil

Myeloma manifesting as a large glomus jugulare tumor: case report
M. Boukobza, J. Guigui, J.P. Guichard, M. Wassef, D. Reizine, P. Tran Ba Huy and
J.J. Merland


Infratemporal fossa approach: the extent of facial nerve mobilization
B.K.H. Pauw, C.J.J. Avezaat, H. van Urk and H.L.J. Tanghe

Extended transpetrosal approach to the petroclival region
O.L. Mendonça Cruz and E.A. da Silva Vellutini

Lateral surgical approaches to the skull base
B. Oliver, P. Tresserras, E. Cardona, V. Gilete, J Molet, P. Parés and F. Bartumeus

Surgical management of transdural tumors
E. Saleh, A. Taibah, A. Russo, A. Mazzoni and M. Sanna

Transotic approach for giant cholesterol granulomas with intracranial extension
B.K.H. Pauw, A.F. Holm and R. Kuhweide


A report of the surgical treatment of temporal bone tumors
W.-S. Lee, H.-K. Lee and C.-H. Cho

The results of surgery for malignant tumors of the skull base
I. Yorulmaz, B. Kucuk, H. Deda and E. Arasil

Malignant tumors of the middle ear
J. Depondt, J.E. Fenton, D. Bouccara, M. Enaux, P. Gehanno and O. Sterkers

Primary tumors of the semicircular canals and vestibule
A.E. Camilleri, L.J. O'Keefe and R.T. Ramsden

Chondroblastoma of the temporal bone: case report
A. Longo, G. Faccani, R. Ferrero, M. Garetto and B. Morra

Fibrous dysplasia and aneurysmal bone cysts of the temporal bone
J.M. Gouin, M. Kalamarides, J.E. Fenton, M. Desgeorges, A. Rey and O. Sterkers


Hemifacial spasm: endoscopic vascular decompression
J. Magnan, A. Chays, F. Caces and R. Locatelli

Rehabilitation of the paralyzed face: results of facial nerve surgery over a 16-year period
S.R. Saeed, L.J. O'Keefe, C. Hartley and R.T. Ramsden

Facial paralysis and petrous bone fractures: an update
G. García-Fructuoso, R.M. Martinez and E. Ferrer


Endoscopic surgery of nasal and paranasal tumors
M.E. Wigand and U. Goede

Endonasal approach to tumors of the anterior skull base: indications and results
O. Michel

New developments in 3-D endonasal and frontobasal endoscopic sinus surgery
W. Freysinger A.R. Gunkel, C. Pototschnig, W.F. Thumfart and M.J. Truppe

Anterior skull base surgery: multidisciplinary improvement
A. Longo, G. Faccani, R. Ferrero, A. Maestri and B. Morra

Craniofacial approach for skull base tumors: our first experience
I.B. Jovanovic, Z.S. Nikolic, Z.D. Djordjec, S.D. Stanisavljec and M.B. Djordjevic

Differential approaches to frontal transbasal meningiomas
D.-K. Böker M. Samii and W. Deinsberger

Skull base reconstruction after craniofacial resection
M.A. Arraez and E. Valencia

Juvenile nasopharyngeal angiofibroma: a discussion of the midfacial degloving approach
and review of therapeutic options. The Royal National Throat, Nose and Ear Hospital experience
J.P. Diver L. Badia, N.O. Turner V.J. Lund, D. Howard and A.D. Cheesman

Naso-maxillary swing approach in huge nasopharyngeal angiofibroma invading the central skull base
J.-H. Yoon and W.-S. Lee

Trans-nasal approach for CSF rhinorrhea
B. Kotecha, J. Diver W. Hellier and A.D. Cheesman

Endonasal treatment for cerebrospinal rhinorrhea of the anterior skull base: a report of six cases
T. Coiffier J. Cabanes, M. Celikoyar A. Visot, C. Freche and F Chabolle

Fractures of the skull base radiating through the sphenoidal body: a report of 57 cases
V. Trabaud, E. Candon, N. Leboucq, G. Veeckmans, Ph. Frerebeau and Ph. Castan

Fronto-orbital cholesterol granulomas: a physiopathological discussion: report of two cases
with a review of the literature
G. Touzet, P Toussaint, S. Milazzo, B. Deschepper and D. Le Gars

Craniofacial skeleton reconstruction: new frontiers
I.P Janecka

Bioactive glass and collagen matrix: two alloplastic materials for frontal sinus obliteration
K. Aitasalo, J Suonpaä and M. Peltola


Review of a series of 204 pituitary adenomas treated surgically
F. Bartumeus, E. Cardona, B. Oliver, M. Rigla, S. Webb, P. Tresserras, V. Gilete, J. Molet,
P. Parés and M. de Juan

Prefixed optic chiasm and the subfrontal-transsphenoidal approach in pituitary adenoma surgery
Y.S. Alexandrov

Functioning ectopic supradiaphragmatic pituitary adenomas
T. Civit, E.H. Dyer J.P. Abecassis and P.J. Derome

Non-secreting pituitary adenomas operated on by lateral rhinotomy followed up for more than five years
B. Petruson, K-E. Jakobsson, J Elfverson and B-å. Bengtsson

Pituitary apoplexy: clinical onset and follow-up of 14 patients
P. Toussaint, F. Proust, S. Milazzo, S. Arlot, C. Gondry, K. Masmoudi and D. Le Gars

Lymphocytic adenohypophysitis: a new case report
C. Desenclos, R Toussaint, S. Milazzo, S. Arlot, J Gondry, C. Gondry and P Rosat

Microsurgical anatomy of the anterior clinoid process
P.D. Tsitsopoulos, C.A. Tsonidis, P.N. Hadjiioannou, G.P Petsas, T.K. Siozos, I.D.
Anagnostopoulos, N. Th. Konstantinidis, S.M. Misirloglou and D.G. Pahatouridis

3-D CT bone reconstruction for sellar-parasellar surgery
W. Liboni, M. Davico, G. Faccani and A. Longo

Suprasellar meningiomas
P. Fiore, S. Paterniti, D. Sacco, A. Levita and S. Cambria

Perisellar meningiomas: surgery, complications and predicting factors
W.-P. Sollmann and F-M. Sens


Embryology of the head and neck for cranial base surgeons
G.L. Rosseau

Lateral sinus thrombosis and associated conditions - the CT ring sign: clinical pathological-imaging aspects:
F. Tovi, Y. Hertzanu, A. Gatot and D. Fliss

Middle ear meningoencephalic herniation: a modified middle cranial fossa technique
M. Arístegui, M. Landolfi, A. Russo, A. Taibeh, E. Saleh and M. Sanna

Primary malignant melanoma of the trigeminal nerve: magnetic resonance imaging characteristics and surgical treatment
E. Gay, J.P. Chirossel, J.G. Passagia and B. Pasquier

Selective metastases in both internal acoustic meatus
F. Salvinelli, C, Colosimo, R. Pallini, A. Carbone and M. Maurizi

Index of Authors

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