Abstract
Introduction: The presigmoid retrolabyrinthine approach (RLA) can provide access to tumors of the internal auditory canal (IAC) and cerebellopontine angle (CPA) while avoiding the morbidity associated with a retrosigmoid (RS) craniotomy and preserving hearing. However, its utilization has been limited by anatomic constraints and line of sight optics of the operating microscope preventing reliable access to the lateral IAC. The introduction of endoscopes and specialized instrumentation may help overcome these limitations by allowing the surgeon to see and work around the posterior semicircular canal. This approach has been reported clinically; however, there have not been extensive anatomic studies detailing the constraints associated with its use, and a standardized method has not become widespread.
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