An extended approach through the middle cranial fossa to the internal auditory meatus and the cerebello-pontine angle.

The submeningeal approach through the middle cranial fossa to the internal auditory meatus and cerebello-pontine angle after cutting the tentorium cerebelli is described. It is in some way similar to that used by Morrison & King. The approach is achieved by drilling the petrous bone to the level of the compact plate of the sigmoid sinus sulcus and to the lumen of the lateral semicircular canal. In this way it is possible to visualize safely the entire auditory-facial fasciculus, the region of the jugular foramen, the IX, X, XI, V, and VI nerves as well as the lateral surface of the brain stem. In our opinion this way should be and is preferable to the translabyrinthine approach through the mastoid process.