{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T12:01:02Z","timestamp":1762516862681,"version":"build-2065373602"},"reference-count":39,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T00:00:00Z","timestamp":1762387200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: The middle cranial fossa (MCF) approach is valued for preserving hearing while accessing the internal auditory canal (IAC), petrous apex, inner ear, and related structures. This study evaluated its clinical outcomes across otolaryngological diseases, focusing on postoperative complications, hearing preservation, and the effect of IAC manipulation on auditory function. Methods: We retrospectively analyzed 35 patients who underwent MCF otologic surgery at a single center over twelve years. We calculated the proportion of MCF cases among all otologic surgeries and assessed postoperative complications and hearing changes (bone conduction thresholds). Outcomes were compared between patients with and without IAC manipulation. Results: MCF procedures comprised 1.4% of all otologic surgeries. Petrous bone cholesteatoma was the leading indication (15 cases). Intracranial complications occurred in 4 patients (11.4%): seizures, epidural abscess, and cerebral infarction. Facial nerve paralysis occurred in 3 (10.7%) patients without any cerebrospinal fluid leaks. In patients without IAC manipulation, hearing functions were preserved (22.3 \u00b1 7.8 dB HL pre- vs. 25.7 \u00b1 9.5 dB HL postoperatively), whereas those with IAC manipulation showed significantly greater deterioration. Conclusions: The middle cranial fossa approach, though technically demanding and infrequently used, offers a safe and effective option across various otolaryngological diseases. This approach achieved favorable hearing preservation with a low complication rate, particularly when intradural manipulation of the IAC was not required.<\/jats:p>","DOI":"10.3390\/jcm14217874","type":"journal-article","created":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T11:41:47Z","timestamp":1762515707000},"page":"7874","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hearing Preservation and Complications of the Middle Cranial Fossa Approach for Otolaryngological Diseases: Twelve-Year Single-Center Experience"],"prefix":"10.3390","volume":"14","author":[{"given":"Toshihito","family":"Sahara","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yujiro","family":"Hoshi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Mitsui Memorial Hospital, Tokyo 101-8643, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3190-3320","authenticated-orcid":false,"given":"Hajime","family":"Koyama","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anjin","family":"Mori","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0028-1343","authenticated-orcid":false,"given":"Yasuhiro","family":"Osaki","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Ikeda City Hospital, Ikeda 563-8510, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akinori","family":"Kashio","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113-8655, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5860-4574","authenticated-orcid":false,"given":"Yasuhiro","family":"Sanada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Kindai University Faculty of Medicine, Osaka-Sayama 589-8511, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6421-0926","authenticated-orcid":false,"given":"Katsumi","family":"Doi","sequence":"additional","affiliation":[{"name":"Ear Center, Iseikai International General Hospital, Osaka 530-0052, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1288\/00005537-196111000-00004","article-title":"Surgical exposure of the internal auditory canal and its contents through the middle cranial fossa","volume":"71","author":"House","year":"1961","journal-title":"Laryngoscope"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.otc.2011.12.010","article-title":"Middle fossa approach: Indications, technique, and results","volume":"45","author":"Angeli","year":"2012","journal-title":"Otolaryngol. 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Diagnostics, 13.","DOI":"10.3390\/diagnostics13020275"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/21\/7874\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T11:55:32Z","timestamp":1762516532000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/21\/7874"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,6]]},"references-count":39,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["jcm14217874"],"URL":"https:\/\/doi.org\/10.3390\/jcm14217874","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,11,6]]}}}