The enlarged middle cranial fossa approach for surgery of the temporal bone and of the cerebellopontine angle.

Due to the fact that the temporal bone has broad segments of bone anterior to and behind the internal auditory canal which are empty of functionally important structures, a broad exposure of the cerebellopontine angle may be obtained from above. This technique is adequate for the management of acoustic neurinomas up to 3 cm in diameter. A low postoperative morbidity and a high percentage of hearing preservation with total tumor removal were obtained in a series of 190 cases. This report underlines the advantages of the procedure and points to various other indications.