Retrolabyrinthine Surgery: A Direct Approach To The Cerebellopontine Angle

Abstract

Two temporal bones are presented that contain acoustic neurinomas unsuspected during life and anatomically limited to the perilymphatic labyrinth. One tumor occupies the modiolus and scala tympani of the cochlea without involving the internal auditory canal. The other tumor originates in the fibers below the utricular macula and spares both the macula and the lamina cribrosa. Neither case demonstrates bone destruction. Even if these tumors had been suspected during life, tomograms would have been normal and the posterior fossa myelogram would have shown complete filling of the internal auditory canal.

Auditory Results After Vestibular Nerve Section and Intratympanic Gentamicin for Ménière's Disease

“…Newer procedures that involved sac decompression or shunting were subsequently developed (27Y30), whereas other groups were attempting to selectively damage or destroy vestibular function in the involved ear without damaging hearing (8,9,31).…”

“…The most widely used treatments for disabling MD are vestibular neurectomy (VN) (8,9) and intratympanic gentamicin (ITG) injection (10Y14).…”

Surgical Treatment of Peripheral Vertigo and Vertiginous Diseases

“…The infralabyrinthine approach was introduced by Vernick [53] in 1990, but did not see wide acceptance. Silverstein and Norrell [54] and Silverstein et al [55,56] used the retrolabyrinthine approach in 1978, retrosigmoid-internal acoustic canal approach in 1985, and retrosigmoid-retrolabyrinthine approach in 1987.…”

Transcochlear approach to a geniculate ganglion hemangioma and reanastomosis of facial nerve

“…Different groups have addressed these lesions via presigmoid or middle fossa approaches [2][3]. When a hemangioma infiltrates the facial nerve, excision of the lesion can be performed with success but at the cost of losing any residual facial nerve function that may be present.…”