The Middle Fossa Approach to Vestibular Schwannomas: The First Ten Years at One Institution

Vestibular schwannomas (acoustic neuromas) are benign, slow-growing tumors of the eight cranial nerve. For patients who undergo surgical management in whom hearing preservation is not an issue, a translabyrinthine approach to these tumors is used. However, when hearing preservation is attempted, the two widely used approaches are the retrosigmoid (RS) approach and the middle fossa (MF) approach. Prior to 1996, our institution used the RS approach for hearing preservation attempts. In an effort to improve our hearing preservation rate, in 1996 we changed to the middle fossa (MF) approach for largely intracanalicular tumors with good hearing.