Middle fossa approach for a facial nerve schwannoma: how I do it.

Facial nerve schwannomas can extend to the middle fossa or the cerebellopontine angle through the labyrinthine and cisternal segments of the facial nerve. The middle fossa approach (MFA) and its extensions provide a wide approach to deal with a large variety of lesions located in the middle and posterior cranial fossa junction. We describe the MFA along with its advantages and limitations to treat a facial nerve schwannoma involving the middle and posterior cranial fossa. The MFA is a well-established route to surgically deal with tumors located in and around the proximal four segments of the facial nerve.