Anatomic logic of the foramen Luschka in neurootologic surgery

The authors emphasise the key role of the state of the foramen Luschka in indication of neurootologic surgical approaches. Blockage of the foramen of Luschka with a medium or big tumour may impaire the CSF circulation. In such case the lateral transtemporal approaches--translabyrinthine and transotic are the best options. In all other situations where there is no blockage of the CSF circulation in the affected pontocerebellar angle the choice of a surgical approach is determined by the state of hearing and character of disease. Surgical indications schould be elective and individually considered.