{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:43:32Z","timestamp":1790084612980,"version":"4.0.1"},"reference-count":32,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,3]]},"abstract":"\n OBJECTIVE<\/jats:title>\n The authors describe their results using an endoscope as an adjunct to microsurgical resection of inferior vestibular schwannomas (VSs) with extension into the fundus of the internal auditory canal below the transverse crest.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n All patients who had undergone middle fossa craniotomy for VSs performed by the senior author between September 2014 and August 2016 were prospectively enrolled in accordance with IRB policies, and the charts of patients undergoing surgery for inferior vestibular nerve tumors, as determined either on preoperative imaging or as intraoperative findings, were retrospectively reviewed. Age prior to surgery, side of surgery, tumor size, preoperative and postoperative pure-tone average, and speech discrimination scores were recorded. The presence of early and late facial paralysis, nerve of tumor origin, and extent of resection were also recorded.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n Six patients (all women; age range 40\u201365 years, mean age 57 years) met these criteria during the study period. Five of the 6 patients underwent gross-total resection; 1 patient underwent a near-total resection because of a small amount of tumor that adhered to the facial nerve. Gross-total resection was facilitated using the operative endoscope in 2 patients (33%) who were found to have additional tumor visible only through the endoscope. All patients had a House-Brackmann facial nerve grade of II or better in the immediate postoperative period. Serviceable hearing (American Academy of Otolaryngology\u2013Head and Neck Surgery class A or B) was preserved in 3 of the 6 patients.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Endoscope-assisted middle fossa craniotomy for resection of inferior vestibular nerve schwannomas with extension beyond the transverse crest is safe, and hearing preservation is feasible.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2017.12.focus17663","type":"journal-article","created":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T03:36:48Z","timestamp":1519875408000},"page":"E7","source":"Crossref","is-referenced-by-count":15,"title":["Endoscope-assisted middle fossa craniotomy for resection of inferior vestibular nerve schwannoma extending lateral to transverse crest"],"prefix":"10.3171","volume":"44","author":[{"given":"Adam N.","family":"Master","sequence":"first","affiliation":[{"name":"Departments of Neurotology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Departments of Neurotology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric P.","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Departments of Neurotology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William H.","family":"Slattery","sequence":"additional","affiliation":[{"name":"Departments of Neurotology and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory P.","family":"Lekovic","sequence":"additional","affiliation":[{"name":"Neurosurgery, House Clinic, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurol Surg Rep","first-page":"e001","article-title":"Endoscopic-assisted middle fossa craniotomy for resection of vestibular schwannoma","volume":"77","author":"Chen BS","year":"2016","unstructured":"Chen BS, Roberts DS, Lekovic GP: Endoscopic-assisted middle fossa craniotomy for resection of vestibular schwannoma. J Neurol Surg Rep 77:e001\u2013e007, 2016"},{"key":"b2","series-title":"Am J Otol","first-page":"382","article-title":"Is the entire fundus of the internal auditory canal visible during the middle fossa approach for acoustic neuroma?","volume":"21","author":"Driscoll CL","year":"2000","unstructured":"Driscoll CL, Jackler RK, Pitts LH, Banthia V: Is the entire fundus of the internal auditory canal visible during the middle fossa approach for acoustic neuroma? Am J Otol 21:382\u2013388, 2000"},{"key":"b3","series-title":"Otol Neurotol","first-page":"1128","article-title":"Fundal fluid as a predictor of hearing preservation in the middle cranial fossa approach for vestibular schwannoma","volume":"31","author":"Goddard JC","year":"2010","unstructured":"Goddard JC, Schwartz MS, Friedman RA: Fundal fluid as a predictor of hearing preservation in the middle cranial fossa approach for vestibular schwannoma. Otol Neurotol 31:1128\u20131134, 2010"},{"key":"b4","series-title":"ORL J Otorhinolaryngol Relat Spec","first-page":"87","article-title":"Evaluation of the results of endoscope-assisted acoustic neuroma surgery through posterior fossa approach","volume":"67","author":"G\u00f6ksu N","year":"2005","unstructured":"G\u00f6ksu N, Yilmaz M, Bayramoglu I, Aydil U, Bayazit YA: Evaluation of the results of endoscope-assisted acoustic neuroma surgery through posterior fossa approach. ORL J Otorhinolaryngol Relat Spec 67:87\u201391, 2005"},{"key":"b5","series-title":"Laryngoscope","first-page":"1363","article-title":"Surgical exposure of the internal auditory canal and its contents through the middle, cranial fossa","volume":"71","author":"House WF","year":"1961","unstructured":"House WF: Surgical exposure of the internal auditory canal and its contents through the middle, cranial fossa. Laryngoscope 71:1363\u20131385, 1961"},{"key":"b6","series-title":"J Neurosurg","first-page":"840","article-title":"Hearing preservation in patients undergoing vestibular schwannoma surgery: comparison of middle fossa and retrosigmoid approaches","volume":"88","author":"Irving RM","year":"1998","unstructured":"Irving RM, Jackler RK, Pitts LH: Hearing preservation in patients undergoing vestibular schwannoma surgery: comparison of middle fossa and retrosigmoid approaches. J Neurosurg 88:840\u2013845, 1998"},{"key":"b7","series-title":"Otolaryngol Head Neck Surg","first-page":"906","article-title":"Facial nerve outcomes in middle cranial fossa vs translabyrinthine approaches","volume":"133","author":"Isaacson B","year":"2005","unstructured":"Isaacson B, Telian SA, El-Kashlan HK: Facial nerve outcomes in middle cranial fossa vs translabyrinthine approaches. Otolaryngol Head Neck Surg 133:906\u2013910, 2005"},{"key":"b8","series-title":"J Neurol Surg B Skull Base","first-page":"42","article-title":"Usefulness of endoscope-assisted microsurgery for removal of vestibular schwannomas","volume":"73","author":"Kumon Y","year":"2012","unstructured":"Kumon Y, Kohno S, Ohue S, Watanabe H, Inoue A, Iwata S, : Usefulness of endoscope-assisted microsurgery for removal of vestibular schwannomas. J Neurol Surg B Skull Base 73:42\u201347, 2012"},{"key":"b9","series-title":"Neurosurgery","first-page":"334","article-title":"Hearing preservation using the middle fossa approach for the treatment of vestibular schwannoma","volume":"70","author":"Kutz JW Jr","year":"2012","unstructured":"Kutz JW Jr, Scoresby T, Isaacson B, Mickey BE, Madden CJ, Barnett SL, : Hearing preservation using the middle fossa approach for the treatment of vestibular schwannoma. Neurosurgery 70:334\u2013341, 2012"},{"key":"b10","series-title":"Otol Neurotol","first-page":"380","article-title":"Small acoustic neuromas: surgical outcomes versus observation or radiation","volume":"27","author":"Meyer TA","year":"2006","unstructured":"Meyer TA, Canty PA, Wilkinson EP, Hansen MR, Rubinstein JT, Gantz BJ: Small acoustic neuromas: surgical outcomes versus observation or radiation. Otol Neurotol 27:380\u2013392, 2006"},{"key":"b11","series-title":"Acta Neurochir (Wien)","first-page":"935","article-title":"Hearing preservation and facial nerve function after microsurgery for intracanalicular vestibular schwannomas: comparison of middle fossa and retrosigmoid approaches","volume":"151","author":"Noudel R","year":"2009","unstructured":"Noudel R, Gomis P, Duntze J, Marnet D, Bazin A, Roche PH: Hearing preservation and facial nerve function after microsurgery for intracanalicular vestibular schwannomas: comparison of middle fossa and retrosigmoid approaches. Acta Neurochir (Wien) 151:935\u2013945, 2009"},{"key":"b12","series-title":"Otol Neurotol","first-page":"1017","article-title":"Middle fossa decompression for hearing preservation: a review of institutional results and indications","volume":"32","author":"Slattery WH","year":"2011","unstructured":"Slattery WH, Hoa M, Bonne N, Friedman RA, Schwartz MS, Fisher LM, : Middle fossa decompression for hearing preservation: a review of institutional results and indications. Otol Neurotol 32:1017\u20131024, 2011"},{"key":"b13","series-title":"J Clin Neurosci","first-page":"1126","article-title":"Hearing preservation rates after microsurgical resection of vestibular schwannoma","volume":"17","author":"Sughrue ME","year":"2010","unstructured":"Sughrue ME, Yang I, Aranda D, Kane AJ, Parsa AT: Hearing preservation rates after microsurgical resection of vestibular schwannoma. J Clin Neurosci 17:1126\u20131129, 2010"},{"key":"b14","series-title":"Laryngoscope","first-page":"1193","article-title":"Adjunctive use of endoscopy during acoustic neuroma surgery","volume":"109","author":"Wackym PA","year":"1999","unstructured":"Wackym PA, King WA, Poe DS, Meyer GA, Ojemann RG, Barker FG, : Adjunctive use of endoscopy during acoustic neuroma surgery. Laryngoscope 109:1193\u20131201, 1999"},{"key":"b15","series-title":"J Neurosurg","first-page":"131","article-title":"Durability of hearing preservation after microsurgical treatment of vestibular schwannoma using the middle cranial fossa approach","volume":"119","author":"Wang AC","year":"2013","unstructured":"Wang AC, Chinn SB, Than KD, Arts HA, Telian SA, El-Kashlan HK, : Durability of hearing preservation after microsurgical treatment of vestibular schwannoma using the middle cranial fossa approach. J Neurosurg 119:131\u2013138, 2013"},{"key":"b16","series-title":"J Neurol Surg B Skull Base","first-page":"333","article-title":"Hearing outcomes after middle fossa or retrosigmoid craniotomy for vestibular schwannoma tumors","volume":"77","author":"Wilkinson EP","year":"2016","unstructured":"Wilkinson EP, Roberts DS, Cassis A, Schwartz MS: Hearing outcomes after middle fossa or retrosigmoid craniotomy for vestibular schwannoma tumors. J Neurol Surg B Skull Base 77:333\u2013340, 2016"},{"key":"b1","series-title":"J Neurol Surg Rep","first-page":"e001","article-title":"Endoscopic-assisted middle fossa craniotomy for resection of vestibular schwannoma","volume":"77","author":"Chen BS","year":"2016","unstructured":"Chen BS, Roberts DS, Lekovic GP: Endoscopic-assisted middle fossa craniotomy for resection of vestibular schwannoma. J Neurol Surg Rep 77:e001\u2013e007, 2016"},{"key":"b2","series-title":"Am J Otol","first-page":"382","article-title":"Is the entire fundus of the internal auditory canal visible during the middle fossa approach for acoustic neuroma?","volume":"21","author":"Driscoll CL","year":"2000","unstructured":"Driscoll CL, Jackler RK, Pitts LH, Banthia V: Is the entire fundus of the internal auditory canal visible during the middle fossa approach for acoustic neuroma? Am J Otol 21:382\u2013388, 2000"},{"key":"b3","series-title":"Otol Neurotol","first-page":"1128","article-title":"Fundal fluid as a predictor of hearing preservation in the middle cranial fossa approach for vestibular schwannoma","volume":"31","author":"Goddard JC","year":"2010","unstructured":"Goddard JC, Schwartz MS, Friedman RA: Fundal fluid as a predictor of hearing preservation in the middle cranial fossa approach for vestibular schwannoma. Otol Neurotol 31:1128\u20131134, 2010"},{"key":"b4","series-title":"ORL J Otorhinolaryngol Relat Spec","first-page":"87","article-title":"Evaluation of the results of endoscope-assisted acoustic neuroma surgery through posterior fossa approach","volume":"67","author":"G\u00f6ksu N","year":"2005","unstructured":"G\u00f6ksu N, Yilmaz M, Bayramoglu I, Aydil U, Bayazit YA: Evaluation of the results of endoscope-assisted acoustic neuroma surgery through posterior fossa approach. ORL J Otorhinolaryngol Relat Spec 67:87\u201391, 2005"},{"key":"b5","series-title":"Laryngoscope","first-page":"1363","article-title":"Surgical exposure of the internal auditory canal and its contents through the middle, cranial fossa","volume":"71","author":"House WF","year":"1961","unstructured":"House WF: Surgical exposure of the internal auditory canal and its contents through the middle, cranial fossa. Laryngoscope 71:1363\u20131385, 1961"},{"key":"b6","series-title":"J Neurosurg","first-page":"840","article-title":"Hearing preservation in patients undergoing vestibular schwannoma surgery: comparison of middle fossa and retrosigmoid approaches","volume":"88","author":"Irving RM","year":"1998","unstructured":"Irving RM, Jackler RK, Pitts LH: Hearing preservation in patients undergoing vestibular schwannoma surgery: comparison of middle fossa and retrosigmoid approaches. J Neurosurg 88:840\u2013845, 1998"},{"key":"b7","series-title":"Otolaryngol Head Neck Surg","first-page":"906","article-title":"Facial nerve outcomes in middle cranial fossa vs translabyrinthine approaches","volume":"133","author":"Isaacson B","year":"2005","unstructured":"Isaacson B, Telian SA, El-Kashlan HK: Facial nerve outcomes in middle cranial fossa vs translabyrinthine approaches. Otolaryngol Head Neck Surg 133:906\u2013910, 2005"},{"key":"b8","series-title":"J Neurol Surg B Skull Base","first-page":"42","article-title":"Usefulness of endoscope-assisted microsurgery for removal of vestibular schwannomas","volume":"73","author":"Kumon Y","year":"2012","unstructured":"Kumon Y, Kohno S, Ohue S, Watanabe H, Inoue A, Iwata S, : Usefulness of endoscope-assisted microsurgery for removal of vestibular schwannomas. J Neurol Surg B Skull Base 73:42\u201347, 2012"},{"key":"b9","series-title":"Neurosurgery","first-page":"334","article-title":"Hearing preservation using the middle fossa approach for the treatment of vestibular schwannoma","volume":"70","author":"Kutz JW Jr","year":"2012","unstructured":"Kutz JW Jr, Scoresby T, Isaacson B, Mickey BE, Madden CJ, Barnett SL, : Hearing preservation using the middle fossa approach for the treatment of vestibular schwannoma. Neurosurgery 70:334\u2013341, 2012"},{"key":"b10","series-title":"Otol Neurotol","first-page":"380","article-title":"Small acoustic neuromas: surgical outcomes versus observation or radiation","volume":"27","author":"Meyer TA","year":"2006","unstructured":"Meyer TA, Canty PA, Wilkinson EP, Hansen MR, Rubinstein JT, Gantz BJ: Small acoustic neuromas: surgical outcomes versus observation or radiation. Otol Neurotol 27:380\u2013392, 2006"},{"key":"b11","series-title":"Acta Neurochir (Wien)","first-page":"935","article-title":"Hearing preservation and facial nerve function after microsurgery for intracanalicular vestibular schwannomas: comparison of middle fossa and retrosigmoid approaches","volume":"151","author":"Noudel R","year":"2009","unstructured":"Noudel R, Gomis P, Duntze J, Marnet D, Bazin A, Roche PH: Hearing preservation and facial nerve function after microsurgery for intracanalicular vestibular schwannomas: comparison of middle fossa and retrosigmoid approaches. Acta Neurochir (Wien) 151:935\u2013945, 2009"},{"key":"b12","series-title":"Otol Neurotol","first-page":"1017","article-title":"Middle fossa decompression for hearing preservation: a review of institutional results and indications","volume":"32","author":"Slattery WH","year":"2011","unstructured":"Slattery WH, Hoa M, Bonne N, Friedman RA, Schwartz MS, Fisher LM, : Middle fossa decompression for hearing preservation: a review of institutional results and indications. Otol Neurotol 32:1017\u20131024, 2011"},{"key":"b13","series-title":"J Clin Neurosci","first-page":"1126","article-title":"Hearing preservation rates after microsurgical resection of vestibular schwannoma","volume":"17","author":"Sughrue ME","year":"2010","unstructured":"Sughrue ME, Yang I, Aranda D, Kane AJ, Parsa AT: Hearing preservation rates after microsurgical resection of vestibular schwannoma. J Clin Neurosci 17:1126\u20131129, 2010"},{"key":"b14","series-title":"Laryngoscope","first-page":"1193","article-title":"Adjunctive use of endoscopy during acoustic neuroma surgery","volume":"109","author":"Wackym PA","year":"1999","unstructured":"Wackym PA, King WA, Poe DS, Meyer GA, Ojemann RG, Barker FG, : Adjunctive use of endoscopy during acoustic neuroma surgery. Laryngoscope 109:1193\u20131201, 1999"},{"key":"b15","series-title":"J Neurosurg","first-page":"131","article-title":"Durability of hearing preservation after microsurgical treatment of vestibular schwannoma using the middle cranial fossa approach","volume":"119","author":"Wang AC","year":"2013","unstructured":"Wang AC, Chinn SB, Than KD, Arts HA, Telian SA, El-Kashlan HK, : Durability of hearing preservation after microsurgical treatment of vestibular schwannoma using the middle cranial fossa approach. J Neurosurg 119:131\u2013138, 2013"},{"key":"b16","series-title":"J Neurol Surg B Skull Base","first-page":"333","article-title":"Hearing outcomes after middle fossa or retrosigmoid craniotomy for vestibular schwannoma tumors","volume":"77","author":"Wilkinson EP","year":"2016","unstructured":"Wilkinson EP, Roberts DS, Cassis A, Schwartz MS: Hearing outcomes after middle fossa or retrosigmoid craniotomy for vestibular schwannoma tumors. J Neurol Surg B Skull Base 77:333\u2013340, 2016"}],"container-title":["Neurosurgical Focus"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/44\/3\/article-pE7.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/44\/3\/article-pE7.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/neurosurg-focus\/44\/3\/article-pE7.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T08:24:07Z","timestamp":1780129447000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/neurosurg-focus\/44\/3\/article-pE7.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3]]},"references-count":32,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3171\/2017.12.focus17663","relation":{},"ISSN":["1092-0684"],"issn-type":[{"value":"1092-0684","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3]]}}}