Middle Cranial Fossa Operations

There are three main operations performed to remove tumours involving the middle or back portion of the skull base.

Translabyrinthine Approach

This is the most commonly performed operation and is used mainly for the removal of vestibular schwannoma (acoustic neuroma). It requires removal of most of the bone around the ear and as a result the hearing is lost on the operated side. However, the majority of patients having this sort of surgery have poor hearing already. By removing the bone, the lining of the brain is exposed and can be opened with minimal brain retraction in order to enable removal of the tumour.

Retrosigmoid Approach

This approach is an alternative to the translabyrinthine approach. It involves cutting a bony window in the skull behind the ear. This technique is useful in patients with small to medium sized tumours and good hearing as it sometimes allows preservation of hearing.

Middle Fossa Approach

This approach involves cutting a window in the bone of the skull immediately above the ear. It can be used to remove small tumours in patients with good hearing as it sometimes allows preservation of hearing.