title: Middle fossa approach for resection of vestibular schwannoma.
abstract: 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.
  
  
  
  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.
  
  
  
  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.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, UT, 84132, USA.
authors.forename: Gmaan
authors.initials: G
authors.lastname: Alzhrani
authors.affiliation: Department of Surgery, Division of Otolaryngology, University of Utah, Salt Lake City, UT, USA.
authors.forename: Clough
authors.initials: C
authors.lastname: Shelton
authors.affiliation: Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, 175 N. Medical Drive East, Salt Lake City, UT, 84132, USA. neuropub@hsc.utah.edu.
authors.forename: William T
authors.initials: WT
authors.lastname: Couldwell
mesh_terms: D035301:Cranial Fossa, Middle / Q000601:surgery*; D006801:Humans; D009464:Neuroma, Acoustic / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*
keywords: Hearing; Middle fossa approach; Resection; Vestibular schwannoma