The transtemporal supralabyrinthine approach: A minimal morbidity access to the internal auditory canal

Abstract

William House pioneered the superolateral middle fossa approach to the internal auditory canal. It was subsequently modified by Ugo Fisch to decrease the morbidity associated with temporal lobe retraction. This transtemporal supralabyrinthine approach has significant advantages over other middle fossa techniques, but few perform it because of unfamiliarity with the surgical steps. Herein the transtemporal supralabyrinthine approach is presented in step-wise detail. The indications and the surgical morbidity are discussed on the basis of 157 patients operated on between 1987 and 1997