{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T23:43:50Z","timestamp":1791330230393,"version":"4.3.1"},"reference-count":63,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2018,6,8]],"date-time":"2018-06-08T00:00:00Z","timestamp":1528416000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The middle cranial fossa (MCF) approach is a challenging surgical technique for the resection of small and intermediate sized, primarily intracanalicular, vestibular schwannomas (VS), with the goal of hearing preservation (HP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To describe a decade-long, single institutional experience with the MCF approach for resection of VS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This is a retrospective cohort study of 63 patients who underwent the MCF approach for resection of VS from 2006 to 2016. Audiometric data included pure-tone average (PTA), low-tone pure-tone average (LtPTA), word recognition score, and American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) hearing classification at presentation and follow-up. Patients with postoperative serviceable (AAO-HNS class A-B) and\/or useful (AAO-HNS class A-C) hearing were compared to those without HP. Facial nerve function was assessed using the House\u2013Brackmann scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      The mean age and duration of follow-up were 50\u00a0\u00b1\u00a013 yr and 21\u00a0\u00b1\u00a021 mo, respectively. The mean tumor size was 10\u00a0\u00b1\u00a04 mm. The serviceable and usable HP rates were 54% and 50%, respectively. Some residual hearing was preserved in 71% of patients. Large tumor size (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.05), volume (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.03), and extrameatal tumor extension (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.03) were associated with poor audiometric outcomes. The presence of a fundal fluid cap (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.01) was a favorable finding. At definitive testing, LtPTA was significantly better preserved than traditional PTA (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.01). Facial nerve outcomes, tumor control rates, and durability of audiometric outcomes were excellent. 47% of patients pursued aural rehabilitation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>In our series, the MCF approach for VS provided excellent rates of tumor and facial nerve function, with durable serviceable HP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opy126","type":"journal-article","created":{"date-parts":[[2018,6,8]],"date-time":"2018-06-08T05:07:34Z","timestamp":1528434454000},"page":"147-158","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":23,"title":["Middle Fossa Approach for Resection of Vestibular Schwannomas: A Decade of Experience"],"prefix":"10.1227","volume":"16","author":[{"given":"Jennifer A","family":"Kosty","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shawn M","family":"Stevens","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, University of Cincinnati Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yair M","family":"Gozal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent A","family":"DiNapoli","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smruti K","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin S","family":"Golub","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Columbia University Irving Medical Center, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norberto O","family":"Andaluz","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myles","family":"Pensak","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, University of Cincinnati Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Zuccarello","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, Ohio"},{"name":"Department of Otolaryngology Head and Neck Surgery, University of Cincinnati Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi N","family":"Samy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Cincinnati Medical Center, Cincinnati, Ohio"},{"name":"Department of Otolaryngology Head and Neck Surgery, University of Cincinnati Medical Center, Cincinnati, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019,2]]},"reference":[{"issue":"6","key":"bib1-20240909","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1016\/j.otohns.2003.08.002","article-title":"Long-term hearing preservation 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