19 - Middle Fossa Craniotomy and Approach to the Internal Auditory Canal or Petrous Apex

Abstract

The middle fossa approach is primarily an extradural approach to the bony structures that make up the floor of the middle fossa. It is the common starting point for the anterior transpetrosal approach with exposure and identification, if necessary, of the internal auditory canal and petroclival junction. In this chapter we describe the indications, contraindications, patient positioning, and operative technique to complete this approach.