Which surgical approach to acoustic neuroma (vestibular schwannoma) provides NO chance of hearing preservation but offers complete removal of even large tumors with direct visualization of the IAC fundus?

• A Retrosigmoid (suboccipital) approach
• B Middle cranial fossa approach
• C Translabyrinthine approach ✓
• D Combined retrosigmoid-translabyrinthine approach

Explanation

The translabyrinthine approach involves drilling through the labyrinth (cochlea and semicircular canals), which irreversibly destroys hearing. Its advantages are direct access to the entire IAC including the fundus, direct visualization of the facial nerve throughout its course, avoidance of cerebellar retraction, and suitability for all tumor sizes regardless of pre-operative hearing. The retrosigmoid approach can preserve hearing but has limited fundal IAC access. The middle cranial fossa approach is best for small intracanalicular tumors with useful hearing.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.