Abstract:The ELD is not vulnerable to injury during IAC dissection using the middle fossa approach. A previous radiographic study has shown that the ELD is violated in 24% of temporal bones during retrosigmoid dissection of the IAC. These findings support and may help explain other outcome studies that show that long-term hearing results are superior with the use of the middle fossa approach when compared to results following retrosigmoid dissection.
“…Unlike the RSC approach, MFC carries a far lower risk of entry into the endolymphatic duct with drilling over the IAC [17,25], and the risk of delayed hearing loss is not significant [24]. Postoperative CSF leak risk is comparable between MFC and TLC, ranging between 1.1% [5] and 5.5% [22 ].…”
The risks and benefits of each treatment option must be weighed for each patient, and management decisions regarding vestibular schwannomas should be individualized for each patient depending on tumor anatomy, patient preferences, and symptoms.
“…Unlike the RSC approach, MFC carries a far lower risk of entry into the endolymphatic duct with drilling over the IAC [17,25], and the risk of delayed hearing loss is not significant [24]. Postoperative CSF leak risk is comparable between MFC and TLC, ranging between 1.1% [5] and 5.5% [22 ].…”
The risks and benefits of each treatment option must be weighed for each patient, and management decisions regarding vestibular schwannomas should be individualized for each patient depending on tumor anatomy, patient preferences, and symptoms.
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