The retrolabyrinthine approach

The development, technique, results, and complications of the retrolabyrinthine/presigmoid approach to the cerebellopontine angle are described. This somewhat overlooked approach allows for potential preservation of hearing and vestibular function and can be applied to the removal of a variety of pathologies in the cerebellopontine angle, including meningiomas, vestibular schwannomas, arachnoid cysts, epidermoid cysts, and other rarer tumors, but is also an option for procedures such as vestibular neurectomy, trigeminal nerve decompression, and auditory brainstem implantation. The addition of contemporary neuromonitoring technology to the approach provides the option for near-real-time monitoring of hearing and facial nerve function during surgery, for overall outcome improvement. The addition of endoscopes to the minimally invasive procedure aids to the surgical field overview, to complete removal of pathology and to preservation of crucial anatomic structures.