Removal of selected infralabyrinthine lesions without facial nerve mobilization

The infralabyrinthine approach can be modified for the removal of certain lesions without facial nerve mobilization. This procedure is to be used for lesions falling under the three following categories: glomus jugulare tumors, infralabyrinthine cholesteatomas, and cholesterol cysts of the temporal bone. This report includes three glomus jugulare tumors (C1 Fisch type) and five infralabyrinthine cholesteatomas operated on with such a technique. Some anatomic data concerning access to the infralabyrinthine area are analyzed. This technique requires very good preoperative imaging screening and is made easier by intraoperative facial nerve monitoring. It can be combined with the translabyrinthine and transcochlear approaches and, if necessary, be modified into an infratemporal approach at any time.