Authors: Mario Sanna, MD; Fernando Mancini, MD; Alessandra Russo, MD; Abdelkader Taibah, MD; Maurizio Falcioni, MD; and Giuseppe Di Trapani, MD
Publisher: Thieme – 310 pages, with 1,007 images
Book Review by: Nano Khilnani

An acoustic neurinoma (sometimes called a vestibular schwannoma or proliferation of Schwann cells) is a tumor, growth, or swelling of nerve tissue arising from the nerve fibers and their myelin sheath. It can cause deafness or lead to other complications, some serious. Acoustic neurinomas are benign or non-cancerous.

The inferior vestibular nerve has typically been their main site (in up to 91 percent of cases) while much of the rest have the superior vestibular nerve as their location. Occasionally the cochlear nerve or the facial nerve may be the site of origin or development of the tumor.

The signs and symptoms of acoustical neurinoma are the following:

  • Hearing loss
  • Tinnitus (ringing in the ear or a sound like a click, hiss or roar)
  • Disequilibrium or loss of balance
  • Cerebellar dysfunction such as ataxia (abnormality of gait), and incoordination
  • Trigeminal nerve dysfunction(e.g. hypoesthesia or paresthesia of midfacial region)
  • Facial nerve dysfunction (e.g. facial nerve palsy, paresis, twitch)
  • Cranial nerve- and brainstem-related symptoms (e.g. aspiration, dysphagia, hoarseness)
  • Hydrocephalus-related symptoms (e.g. diplopia, headache, papilledema, vomiting

This book was written primarily for otologists (hearing specialists), otolaryngologists (ear and throat specialists), neurologists and neurosurgeons (brain specialists). This second edition was developed to provide updated information – text and images – and share the benefits of the experience and insights gathered by the six authors named above, on acoustic neurinoma microsurgery, in the period between publication the first edition of this book in 1998 and this current second edition in 2010.

Dr. Mario Sanna, the lead author of this book, writes: “Now having performed almost 3500 procedures on posterior fossa lesions and more than 2,000 procedures on acoustic neurinoma, we feel strongly that we need to update the techniques as well as the results obtained with this kind of surgery.”

This large-format book with more than a thousand illustrations, covers a lot of topics. To give you an overview, and to help you quickly search for information on specific subjects, we list below the titles of its 14 chapters:

  1. General Features of Acoustic Neurinoma
  2. Imaging Study of Acoustic Neurinoma
  3. Decision Making in Acoustic Neurinoma Surgery
  4. Operating Room Setup and Patient Care
  5. Surgery in the Cerebellopontine Angle: General Concepts
  6. Intraoperative Monitoring
  7. The Translabyrinthine Approaches
  8. Combined Retrosigmoid-Retrolabyrinthine Approach
  9. Enlarged Middle Cranial Fossa Approach
  10. Transcochlear Approaches
  11. Management in Special Situations
  12. Facial Nerve Reanimation
  13. The Role of Endoscopy in Acoustic Neurinoma Surgery
  14. Complications and Management

Among the updates in this second edition are:

  • Technical modifications in acoustic neurinoma microsurgery
  • Two new chapters
  • Emphasis on intraoperative monitoring of the facial nerve and the cochlear nerve as now being essential in the removal of acoustic neurinoma
  • Development of the ability to offer more treatment options to patients with neurofibromatosis type 2

Cases derived from the authors’ experience are used to explain and illustrate clinical applications of various techniques, as well as provide advice as to what to do when faced with surgical complications.

This is an excellent, useful, and very valuable textbook. It is a black-and-white and full-color visual guide that can help you acquire the necessary knowledge and develop critical skills in having good outcomes in acoustic neurinoma microsurgery.



Mario Sanna, MD is Professor of Otolaryngology in the Department of Head and Neck Surgery at the University of Chieti in Chieti, Italy. He is also affiliated with Gruppo Otologico in Piacenza and Rome, Italy.

Fernando Mancini, MD works at or is affiliated with Gruppo Otologico, Casa di Cura “Piacenza” in Piacenza and Rome, Italy. He is also affiliated with Ospetale Koelleker in Turin, Italy.

Alessandra Russo, MD works at or is affiliated with Gruppo Otologico, Casa di Cura “Piacenza” in Piacenza and Rome, Italy.

Abdelkader Taibah, MD works at or is affiliated with Gruppo Otologico, Casa di Cura “Piacenza” in Piacenza and Rome, Italy.

Maurizio Falcioni, MD works at or is affiliated with Gruppo Otologico, Casa di Cura “Piacenza” in Piacenza and Rome, Italy.

Giuseppe Di Trapani, MD works at or is affiliated with Gruppo Otologico, Casa di Cura “Piacenza” in Piacenza and Rome, Italy.


With the collaboration of:
Antonio Caruso
Kevin Chong
Giuseppe de Donato
Masashi Hamada
Lorenzo Lauda
Enrico Piccirillo
Roberto Rizzoli