CNC Hearing and Balance Center Neurotologist Moises Arriaga discusses the translabyrinthine approach that surgeons utilize to access and remove acoustic tumors in the brain.
When acoustic tumors involve the hearing and balance nerve or involve the brain next to where the hearing and balance nerve leaves the base of the skull, the translabyrinthine approach is a very useful way of safely removing the tumor and protecting the brain. In this operation, we make a cut behind the ear and then actually go through this bone called the mastoid bone and carefully remove the inner ear to allow us access to the nerves that come from the brain, including the hearing and balance and face nerve as well as to this whole area of the brain, without having to put pressure on the brain.
Because removing this bone opens up a huge window for the neurosurgeon to be able to access these areas as we work together to remove acoustic tumors that involve the base of the skull. In this fashion,we are able to have two places where we see the nerve of the face. We see it as it’s entering the inner ear and we see it as it’s just leaving the brain, entering the tumor itself.
The translabyrinthine approach is a tried and true skull-based strategy for accessing acoustic tumors-it allows us to access small tumors just involving the internal auditory canal or large tumors that have caused significant destruction but by using bone to reach the tumor, we therefore avoid compressing the brain. We are in an advantageous position of identifying the facial nerve and we’ve got very good techniques for limiting complications like leakage of spinal fluid and problems resulting from pressure