Middle Cranial Fossa Approach for Sporadic Vestibular Schwannoma: Patient Selection, Technical Pearls, and Hearing Results

Rustin G Kashani; Armine Kocharyan; Alexander D Claussen; Bruce J Gantz; Marlan R Hansen

doi:10.1016/j.otc.2023.02.009

Middle Cranial Fossa Approach for Sporadic Vestibular Schwannoma: Patient Selection, Technical Pearls, and Hearing Results

Otolaryngol Clin North Am. 2023 Jun;56(3):495-507. doi: 10.1016/j.otc.2023.02.009. Epub 2023 Apr 3.

Authors

Rustin G Kashani¹, Armine Kocharyan¹, Alexander D Claussen¹, Bruce J Gantz¹, Marlan R Hansen²

Affiliations

¹ Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, University of Iowa, Iowa City, IA 52242, USA.
² Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, University of Iowa, Iowa City, IA 52242, USA. Electronic address: marlan-hansen@uiowa.edu.

PMID: 37019769
DOI: 10.1016/j.otc.2023.02.009

Abstract

The middle fossa approach is an excellent technique for removing appropriate vestibular schwannomas in patients with serviceable hearing. Knowledge of the intricate middle fossa anatomy is essential for optimal outcomes. Gross total removal can be achieved with preservation of hearing and facial nerve function, both in the immediate and long-term periods. This article provides an overview of the background and indications for the procedure, a description of the operative protocol, and a summary of the literature on postoperative hearing outcomes.

Keywords: Hearing preservation; Middle fossa approach; Resection; Surgical outcomes; Vestibular schwannoma.

Publication types

Review

MeSH terms

Cranial Fossa, Middle / surgery
Hearing / physiology
Humans
Neuroma, Acoustic* / surgery
Neurosurgical Procedures / methods
Patient Selection
Postoperative Complications / surgery
Retrospective Studies
Treatment Outcome