Middle Fossa Approach (Anterior Transpetrosal/Subtemporal Approach)

Abstract

The most common indications for this approach are repair of superior semicircular canal dehiscence and approach to the IAC for acoustic neuroma resections. Usually small, intracanalicular tumors with good hearing are approached via this route. Vestibular nerve section and total facial nerve decompression, CSF leak, and meningocele repair are other less common indications for this approach. There is significant temporal lobe retraction during this approach, so this makes it less suitable for older patients.