title: Middle fossa approach: Applications in temporal bone lesions.
abstract: The middle fossa approach is a surgical technique that is very useful for lateral skull base surgery. However, it is true that it has limited surgical indications and implementation due to its technical complexity. We present our experience in 10 patients in whom the middle fossa approach was the treatment of choice because of the extent of the injury and complexity of the lesion or process. Despite the complexity of the cases, there was no mortality associated with surgery. Postoperative complications were found in 2 patients who presented an epidural hematoma and a cortico-subcortical hematoma. Hearing function was preserved in 5 patients out of the 7 who had adequate hearing at the time of surgery. House/Brackmann I-II facial nerve function was achieved in 8 patients; the remaining 2 had no deterioration of the nerve function. In 9 out of 10 patients, the surgery achieved complete solution of the lesion. The middle fossa approach is a safe and reliable surgical technique. It gives us great control and exposure of different skull base processes. We consider its knowledge of great importance, because it may be the only viable surgical alternative in some specific patients. That is the reason why it is important to learn this approach and know about it in our specialty.
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitari de Bellvitge , L'Hospitalet de Llobregat, Barcelona, España. Electronic address: ivandomenech@amiq.cat.
authors.forename: Iván
authors.initials: I
authors.lastname: Domenech Juan
authors.affiliation: Agrupació Mèdica i Quirúrgica (AMiQ), Unidad Funcional de Otorrinolaringología y Alergia, Hospital Universitario Quirón Dexeus, Barcelona, España.
authors.forename: Paula
authors.initials: P
authors.lastname: Cruz Toro
authors.affiliation: Agrupació Mèdica i Quirúrgica (AMiQ), Unidad Funcional de Otorrinolaringología y Alergia, Hospital Universitario Quirón Dexeus, Barcelona, España.
authors.forename: Ángela
authors.initials: Á
authors.lastname: Callejo Castillo
authors.affiliation: Agrupació Mèdica i Quirúrgica (AMiQ), Unidad Funcional de Otorrinolaringología y Alergia, Hospital Universitario Quirón Dexeus, Barcelona, España.
authors.forename: Rafael
authors.initials: R
authors.lastname: Moya
authors.affiliation: Agrupació Mèdica i Quirúrgica (AMiQ), Unidad Funcional de Otorrinolaringología y Alergia, Hospital Universitario Quirón Dexeus, Barcelona, España.
authors.forename: Jorge L
authors.initials: JL
authors.lastname: Merán Gil
authors.affiliation: Servicio de Otorrinolaringología, Hospital Universitari de Bellvitge , L'Hospitalet de Llobregat, Barcelona, España.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Bartel
mesh_terms: D000328:Adult; D002781:Cholesteatoma / Q000601:surgery; D004677:Encephalocele / Q000601:surgery; D005158:Facial Paralysis / Q000209:etiology / Q000517:prevention & control; D005260:Female; D034381:Hearing Loss / Q000209:etiology / Q000517:prevention & control; D006391:Hemangioma / Q000601:surgery; D006406:Hematoma / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000601:surgery; D013701:Temporal Bone / Q000473:pathology / Q000601:surgery*
keywords: Abordaje fosa media; Cholesteatoma; Cholesterol granuloma; Colesteatoma; Epidermoid tumour; Facial palsy; Granuloma de colesterol; Hearing preservation; Middle fossa approach; Parálisis facial; Preservación auditiva; Tumor epidermoide