Middle cranial fossa approach for acoustic neuroma

Abstract

The middle fossa approach for the resection of small acoustic neuromas is a viable, but underutilized treatment modality with the goal of hearing preservation. The authors aim to demonstrate this approach and its nuances through this video presentation. A 38-year-old man presented with an incidentally discovered small, intracanalicular acoustic neuroma that was initially observed, but growth was noted. The patient had good hearing, and therefore a hearing preservation approach was offered. A gross-total resection was achieved, and the patient maintained good hearing postoperatively. This video demonstrates relevant anatomy, surgical indications, technical aspects of resection, including reconstruction, and postoperative outcomes. The video can be found here: https://stream.cadmore.media/r10.3171/2021.7.FOCVID21124

Sinus tympani revisited for planning retrofacial approach—radiologic study in pneumatized temporal bones and its surgical implications

“…Both authors are aware of potential risks-damaging the posterior semicircular canal and stapedius muscle. It may seem that the experience gained by drilling for blue line of anterior semicircular canal during middle fossa approach for vestibular schwannoma resection or vestibular neurectomy may be of use when practicing RFA [34]. When a surgeon wants to prevent an accidental damage, the main objective is to find posterior semicircular canal and to expose its blue line [12].…”