Suboccipital Craniectomy for Acoustic Neuroma


This surgery is used to remove an acoustic neuroma, a type of noncancerous tumor that forms on a nerve in the middle ear. The procedure is performed under general anesthesia and requires a hospital stay.


In preparation for the procedure, the patient is anesthetized and the patient's head is secured. A portion of the scalp is shaved.

Nerve Monitoring

Electrodes are placed on the face so the surgeon can monitor the health of the sensitive facial and other cranial nerves. These nerves are sensitive and delicate. Monitoring helps the surgeon avoid causing damage to them during the surgery.

Accessing the Skull

The surgeon creates an incision in the scalp behind the ear. The skin is pulled back to expose the skull.

Opening the Skull

The surgeon creates a small hole in the skull, and opens the dura. This is the membrane that covers the brain.

Inserting the Instruments

The surgeon gently moves the cerebellum away from the surgical site, and uses an operating microscope to magnify the area.

Reaching the Tumor

The surgeon inserts soft, flexible retractors to hold healthy tissues, exposing the acoustic neuroma. Sometimes the bone that covers the inner ear must be drilled away to fully expose the mass.

Clearing the Tumor

The surgeon uses microsurgical instruments to gently separate the tumor from the surrounding nerves. The surgeon carefully removes the tumor.

End of Procedure

The surgeon seals any open air cells in the bone with wax or with a bone substitute. The surgeon closes the dura, and patches the opening in the skull with bone cement or titanium mesh. The incision in the scalp is closed.

After Care

The patient will require several days in the hospital for monitoring. During recovery, the patient's cognitive and physical abilities are tested. The patient will receive therapy if needed. Full recovery usually takes a few months. The patient may feel fatigued during this time. A tumor that has damaged the surrounding nerves may affect hearing and facial expression.