Abstract
We originally described the transcranial translabyrinthine approach (TCTL) to acoustic
neuroma. The approach is a labyrinthine dissection that is performed via the suboccipital
exposure. It allows a complete and direct visualization of the internal auditory canal
and the identification of the facial nerve at "Bill's bar." The TCTL enhances the
suboccipital approach and adapts to its concepts of the classical transmastoid translabyrinthine
approach. We hereby report our initial experience with the TCTL and present the surgical
results in six additional cases. We also discuss the indications of this approach
and compare it to alternative approaches that are used for the removal of large acoustic
neuromas that extend laterally in the internal auditory canal.
