Endolymphatic Duct Status During Middle Fossa Dissection of the Internal Auditory Canal: A Human Temporal Bone Radiographic Study

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.

Controversies in building a management algorithm for vestibular schwannomas

“…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 ].…”