Gmaan Alzhrani1, Clough Shelton2, William T Couldwell3. 1. Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, UT, 84132, USA. 2. Department of Surgery, Division of Otolaryngology, University of Utah, Salt Lake City, UT, USA. 3. Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, UT, 84132, USA. neuropub@hsc.utah.edu.
Abstract
BACKGROUND: Surgical approaches for removal of vestibular schwannoma are done through retrosigmoid, translabyrinthine, or middle fossa approaches, depending on the tumor size, preoperative hearing status, surgical team experience, and patient preference. The middle fossa approach (MFA) for the vestibular schwannoma (VS) route preserves hearing and can be done with minimal morbidity and mortality. METHOD: The authors discuss the surgical anatomy of the middle fossa, internal auditory canal localization techniques, MFA indications and the procedure for VS removal, and outcome. CONCLUSION: Unlike otolaryngologists, who use the MFA to treat various pathological processes that involve the inner or middle ear, many neurosurgeons are unfamiliar with the MFA. Nevertheless, learning the technical nuances of the MFA adds to the neurosurgeon's armamentarium, especially for treatment of small intracanalicular VSs in young patients who wish to preserve hearing.
BACKGROUND: Surgical approaches for removal of vestibular schwannoma are done through retrosigmoid, translabyrinthine, or middle fossa approaches, depending on the tumor size, preoperative hearing status, surgical team experience, and patient preference. The middle fossa approach (MFA) for the vestibular schwannoma (VS) route preserves hearing and can be done with minimal morbidity and mortality. METHOD: The authors discuss the surgical anatomy of the middle fossa, internal auditory canal localization techniques, MFA indications and the procedure for VS removal, and outcome. CONCLUSION: Unlike otolaryngologists, who use the MFA to treat various pathological processes that involve the inner or middle ear, many neurosurgeons are unfamiliar with the MFA. Nevertheless, learning the technical nuances of the MFA adds to the neurosurgeon's armamentarium, especially for treatment of small intracanalicular VSs in young patients who wish to preserve hearing.
Authors: Robert C Rennert; Michael G Brandel; Jeffrey A Steinberg; Rick A Friedman; William T Couldwell; Takanori Fukushima; John D Day; Alexander A Khalessi; Michael L Levy Journal: Sci Rep Date: 2022-03-03 Impact factor: 4.379
Authors: Pablo González-López; Carlos Martorell-Llobregat; Vladimír Beneš; Roy T Daniel Journal: Acta Neurochir (Wien) Date: 2022-04-06 Impact factor: 2.816