Surgical anatomy for the extended middle cranial fossa approach

The surgical anatomy of the temporal bone and the cerebellopontine angle was studied in cadavers, by performing simulated surgery via the extended middle cranial fossa approach. This approach is classified into 3 types according to extension of the drilling area of the temporal bone. In this paper, the surgical anatomy visualized by the EMCF type II and type III is described. In the EMCF type II, mastoidectomy and labyrinthectomy are performed completely through the middle cranial fossa, and in the EMCF type III permitting hearing preservation surgery, sections of the middle cranial fossa dura and the cerebellar tentorium are added to House's middle cranial fossa approach. The comprehension of these anatomical structures is essential for surgeons in performing acoustic neuroma surgery. We believe that this study will serve to expand our knowledge of surgical anatomy, and that as a result the EMCF approach for acoustic neuroma surgery will become more popular.