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Hiroshi Ryu, Seiji Yamamoto, Kenji Sugiyama, Kenichi Uemura and Tsunehiko Miyamoto

of HFS at REZ  3 yrs later 2nd op (8/22/94): NVD of branch HFS resolved of PICA at mid CN VII 7 36, F lt ‡ op (11/1/95): no NVC at REZ; HFS resolved NVD of AICA at internal auditory meatus * Mid CN VII = midportion of seventh cranial nerve; NVC = neurovascular compression; NVD = neurovascular decompression. † Dates of operation are given parenthetically as month/day/year. † Atypical HFS. Case 4 This 51-year-old woman had undergone

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Hiroshi Ryu, Seiji Yamamoto, Kenji Sugiyama and Kenichi Uemura

. Bilateral vestibular functions were normal for caloric responses, gaze nystagmus, saccadic eye movements, the eye tracking test, and optokinetic nystagmus. Computerized tomography and magnetic resonance imaging showed no abnormalities. The possibility of neurovascular compression syndromes was also checked using magnetic resonance imaging 3 but no vascular compression was detected. At first, we hesitated to perform total sectioning of the eighth cranial nerve because the patient's hearing on the left side was almost normal. After the procedure, the patient would

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Hiroshi Ryu, Seiji Yamamoto, Kenji Sugiyama, Kenichi Uemura and Michihiko Nozue

simply told by their doctor that they will just have to learn to live with it. 3 Neurovascular compression (NVC) of the eighth cranial nerve has also been reported as a cause of tinnitus, 1, 2, 10–12, 14–18, 20, 25 but few reports describe the characteristics of this condition, 13, 15, 20 making it very difficult to diagnose tinnitus correctly. Furthermore, it is almost impossible to predict whether tinnitus will resolve after neurovascular decompression (NVD), even if the patient presents with signs strongly suggestive of NVC. 14 The reason for the lack of

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Hiroshi Ryu, Tokutaro Tanaka, Seiji Yamamoto, Kenichi Uemura, Yasuo Takehara and Haruo Isoda

surgery. Conclusions The detailed anatomy of intracranial structures has been studied mainly in cadavers, but the absence of CSF and blood pressure distorts normal spatial relationships. This is especially true of the FN and the three components of the eighth cranial nerve and surrounding blood vessels in the IAC and the cerebellopontine cistern. Magnetic resonance cisternography provides quite detailed anatomical information about these structures and enables correct diagnosis of neurovascular compression of the eighth cranial nerve, preoperative identification of the