Translabyrinthine Approach

Approaches to Skull Base

I Anterior Cranial Base

Anterior craniofacial resection
Basal subfrontal approach

II Middle Cranial Base

Central Compartment

Trans septal sphenoid
Transpalatal
Extended maxillotomy
Midfacial split

Lateral Compartment

Infratemporal fossa approach l case 1 l case 2
Transparotid
Subtemporal preauricular infratemporal fossa approach
Trans facial approaches

Facial translocation approach l case 1 l case 2
Extended osteoplastic maxillotomy approach
Extended transfacial subcranial approach l case 1 l case 2

III Posterior cranial base

Transtemporal approaches

Translabyrinthine approach
Transotic approach
Transcochlear approach l Case 1 l Case 2

Extreme lateral/transcondylar approach

Skull Base Surgery

Translabyrinthine Approach

A 72 year old female presented with deafness and tinnitus in the right ear and loss of taste in the right half of the tongue of 2 years duration. She also had numbness on the right side of the face and ear over a period of 6 months duration. MRI was suggestive of an acoustic neuroma producing a cone shaped mass in the right cerebellopontine angle. Intracanalicular component had widened the internal auditory meatus (IAM). The tumour was excised using the translabyrinthine approach.


Schematic view of the area of bone removal in translabyrinthine exposure.		Preoperative MRI shows the tumour in the CP angle.

Complete mastoidectomy is done.		Posterior labyrinthectomy is being done. Semicircular canals are opened.

Superior, posterior and inferior bony walls of the IAC are drilled out exposing the contents of IAC covered by the dura.		Postoperative CT shows no residual tumour.