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Excerpt
I would like to comment on the article on eighth-nerve surgery by Drs. Jackler and Whinney (1). In 1987, my colleagues and I developed the combined retrolabyrinthine-retrosigmoid approach, which is essentially a limited retrosigmoid approach to the cerebellopontine angle. We have used this approach exclusively since 1987 in 125 vestibular neurectomy cases (2–11). In this approach, the lateral sinus is skeletonized and retracted anteriorly to allow access to the posterior wall of the temporal bone, which provides rapid exposure of the eighth-nerve complex with minimal cerebellar retraction. This approach has essentially eliminated cerebrospinal fluid leak, which was present in 10% of patients when the retrolabyrinthine approach was used. We also have not found it necessary to drill the internal auditory canal for better exposure of the cleavage plane, because the results are the same when the transection is performed near the brainstem.
