Translabyrinthine approach

The translabyrinthine approach is a surgical approach to the cerebellopontine angle, or CPA. It is used in the surgical extirpation of lesions of the cerebellopontine angle, including acoustic neuroma

Acoustic neuroma

A vestibular schwannoma, often called an acoustic neuroma, is a benign primary intracranial tumor of the myelin-forming cells of the vestibulocochlear nerve . The term "vestibular schwannoma" involves the vestibular portion of the 8th cranial nerve and arises from Schwann cells, which are...

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The translabyrinthine approach was developed by William F. House, M.D., founder of the House Ear Institute

House Ear Institute

The House Ear Institute is a non-profit 501 organization, based in Los Angeles, and dedicated to advancing hearing science through research and education to improve quality of life. Established in 1946 by Howard P...

http://www.hei.org, who began doing dissections in the laboratory with the aid of magnification and subsequently developed the first middle cranial fossa

Middle cranial fossa

The middle fossa, deeper than the anterior cranial fossa, is narrow medially and widens laterally to the sides of the skull. It is separated from the posterior fossa by the clivus and the petrous crest....

 and then the translabyrinthine approach for the removal of acoustic neuroma

Acoustic neuroma

A vestibular schwannoma, often called an acoustic neuroma, is a benign primary intracranial tumor of the myelin-forming cells of the vestibulocochlear nerve . The term "vestibular schwannoma" involves the vestibular portion of the 8th cranial nerve and arises from Schwann cells, which are...

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This surgical approach is typically performed by a team of surgeons, including a neurotologist (an ear, nose, and throat surgeon specializing in skull base surgery) as well as a neurosurgeon.

In this approach, the semicircular canals and vestibule, including the utricle and the saccule of the inner ear

Inner ear

The inner ear is the innermost part of the vertebrate ear. In mammals, it consists of the bony labyrinth, a hollow cavity in the temporal bone of the skull with a system of passages comprising two main functional parts:...

are removed with a surgical drill, causing complete sensorineural hearing loss in the operated ear. The facial nerve, which innervates the muscles the of face, is presevered in a higher percentage of cases than other approaches.

Prior to the translabyrinthine approach, in the early 1960's acoustic neuromas were treated utilizing a suboccipital approach without the aid of an operating microscope. With the introduction of the translabyrinthine approach, mortality rates decreased from 40% in the State of California to 1%.