Commentary

The presigmoid retrolabyrinthine approach is very useful for small lesions involving the cerebellopontine angle and vestibulocochlear nerve complex and for vestibular neurectomy. It also can be combined with a supratentorial craniotomy to access lesions of the petroclival region that may extend above or below the tentorium. The benefit of the retrolabyrinthine approach is that the surgeon primarily works in the presigmoid region. Consequently, the posterior extent of the craniotomy and possibly some of the soft tissue dissection can be limited. The disadvantage is that access to the medial cerebellopontine angle is limited. An extension of this approach, the partial labyrinthectomy, has been reported to be associated with good preservation of hearing while improving access to the cerebellopontine angle. Although we have not attempted this technique at our institution, we are interested in the experience of other centers. Overall, this excellent article reminds both neurosurgeons and neuro-otologists of the versatility and usefulness of this approach.