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The records of 10 patients, who underwent removal of small vestibular schwannomas by the middle cranial fossa approach at the University of Iowa Department of Otolaryngology and Maxillofacial Surgery between October 1974 and November 1977, are reviewed. The principal deviation from previously described operative techniques is that after identification of appropriate landmarks, the internal auditory canal is first unroofed in its medial portion near the porus rather than following the facial nerve to the fundus of the canal. There were no intraoperative complications, but one patient died after a postoperative brain stem vascular accident. Another patient developed a cerebrospinal fluid leak and, subsequently, meningitis. Auditory function was preserved postoperatively in 8 of 10 patients, but only 6 retained auditory function after discharge from the hospital. Facial nerve function was normal immediately after surgery in 6 of the 10 patients, but return was incomplete in 2 patients more than 1 year after surgery. Postoperative routine and special audiometric studies are discussed.

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