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Middle Fossa Approach

Last Updated: September 30, 2018

Resection of an Acoustic Neuroma through the Middle Cranial Fossa Approach

For general considerations, clinical presentation, and evaluation of vestibular schwannomas (VSs), please refer to the Retrosigmoid Approach for Acoustic Neuroma chapter.

Indications for the Middle Cranial Fossa Approach

The main indications for the middle cranial fossa (MCF) approach include removal of a small predominately intracanalicular VS, exposure of the labyrinthine and upper tympanic segments of the facial nerve for decompression, vestibular nerve section, and repair of superior semicircular canal dehiscence.

Historically, the MCF approach offers some of the highest hearing preservation rates, but it can also place the facial nerve between the surgeon and the tumor, potentially leading to a higher risk...