{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T17:35:04Z","timestamp":1788197704446,"version":"build-2803163510"},"reference-count":17,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Surgical access to the internal auditory canal (IAC) fundus is a crucial aspect of the retrosigmoid approach for hearing preservation surgery in vestibular schwannoma. An appropriate positioning of the retrosigmoid craniotomy is necessary to obtain an adequate surgical corridor for full fundus exposure and labyrinth preservation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE:<\/jats:title>\n                    <jats:p>To describe how the position of the posterior edge of the access related to the probability of exposing the fundus and to propose novel criteria for positioning the retrosigmoid craniotomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Data on fundus exposure were retrospectively collected in 33 consecutive cases of sporadic vestibular schwannoma, submitted to the retrosigmoid craniotomy in a park-bench position. Patients' computed tomography images were analyzed to calculate the position of the posterior edge of the craniotomy with reference to the fundus\u2013labyrinth line (FLL), which starts at the fundus and, running just posterior to the labyrinth, reaches the occipital squama. A logistic regression model was used to correlate the craniotomy position with the probability of exposing the fundus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      The fundus exposure rate was significantly higher (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .005) for craniotomies located posteromedially to the FLL. In a logistic regression model, the probability of exposing the fundus reached 95% for craniotomies located 11.3 mm posteromedially to the FLL.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION:<\/jats:title>\n                    <jats:p>This study showed a strong association between craniotomy position and fundus exposure rate. Our findings suggest that the posteromedial edge of the retrosigmoid craniotomy should lie approximately 11 mm posteromedially to FLL to maximize the chances of exposing the fundus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1227\/ons.0000000000000083","type":"journal-article","created":{"date-parts":[[2022,1,6]],"date-time":"2022-01-06T11:02:47Z","timestamp":1641466967000},"page":"179-186","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":6,"title":["Position of Retrosigmoid Craniotomy in Hearing Preservation Surgery for Vestibular Schwannoma"],"prefix":"10.1227","volume":"22","author":[{"given":"Leonardo","family":"Franz","sequence":"first","affiliation":[{"name":"Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy;"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, University of Toronto, Toronto, Canada;"},{"name":"Guided Therapeutics (GTx) Lab, University Health Network, Toronto, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Mazzoni","sequence":"additional","affiliation":[{"name":"Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Martini","sequence":"additional","affiliation":[{"name":"Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"d\u2019Avella","sequence":"additional","affiliation":[{"name":"Department of Neuroscience DNS, Academic Neurosurgery, University of Padova, Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabetta","family":"Zanoletti","sequence":"additional","affiliation":[{"name":"Department of Neuroscience DNS, Otolaryngology Section, University of Padova, Padova, Italy;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,1,6]]},"reference":[{"issue":"11","key":"R1-20251027","doi-asserted-by":"crossref","first-page":"2034","DOI":"10.3174\/ajnr.A5213","article-title":"The management and imaging of vestibular schwannomas","volume":"38","author":"Lin","year":"2017","journal-title":"AJNR Am J Neuroradiol."},{"issue":"3","key":"R2-20251027","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1097\/MAO.0b013e318245cf01","article-title":"Impact of fundal extension on hearing after surgery for vestibular schwannomas","volume":"33","author":"Nguyen","year":"2012","journal-title":"Otol Neurotol."},{"issue":"4","key":"R3-20251027","doi-asserted-by":"crossref","first-page":"527","DOI":"10.3171\/jns.2006.105.4.527","article-title":"Improved preservation of hearing and facial nerve function in vestibular schwannoma surgery via the retrosigmoid approach in a series of 200 patients","volume":"105","author":"Samii","year":"2006","journal-title":"J Neurosurg."},{"issue":"5","key":"R4-20251027","doi-asserted-by":"crossref","first-page":"677","DOI":"10.3171\/jns.1992.77.5.0677","article-title":"The significance for postoperative hearing of preserving the labyrinth in acoustic neurinoma surgery","volume":"77","author":"Tatagiba","year":"1992","journal-title":"J Neurosurg."},{"issue":"9","key":"R5-20251027","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1097\/MAO.0b013e3181f7ab47","article-title":"Hearing preservation in retrosigmoid approach of small vestibular schwannomas: prognostic value of the degree of internal auditory canal filling","volume":"31","author":"Tringali","year":"2010","journal-title":"Otol Neurotol."},{"issue":"1","key":"R6-20251027","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1007\/s00701-018-3739-x","article-title":"Hearing preservation in small acoustic neuroma: observation or active therapy? 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