Removal of vestibular schwannomas through the middle cranial fossa surgical approach

Fifteen cases of intracanalicular vestibular schwannomas excised through the middle cranial fossa technique are analysed. Postoperative evaluation indicated four patients with normal SRT's, seven with improved SDS's, and one with total deafness. Facial nerve motor function was normal in 12 cases, two presented grade II and one presented grade TV paralysis. Tinnitus was not absent in two patients before and after surgery; in five there was suppression or relief; in five cases it remained unchanged and in three it there was onset or increase. There were no postoperative complications or deaths. The authors feel that the middle cranial fossa approach is a safe procedure, with small risk to the facial nerve and good probability of preservation or improvement of the patient's hearing.