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Background and Objectives:Modern imaging and surgical techniques have made intrameatal vestibular schwanoma (IMVS) surgery safe and have allowed for good outcomes with respect to facial nerve function and hearing outcome. This study aimed to analyze clinical features and to compare the results of the middle fossa approach (MFA) and translabyrinthine approach (TLA) used during IMVS surgery. Subjects and Method:We reviewed retrospectively 10 patients who were operated for IMVS from November 1995 to May 2005. This study analyzed chief complaint, size of tumor, audiological studies, caloric test, imaging study, and treatment modality. Results:The main symptom for IMVS patients is vertigo. But, in our study, patients having only vertigo was rare;disturbance in PTA and unilateral weakness in the Caloric test. In terms of mean operation time, it took 7.5 hours in MFA and 4 hours in TLA. Postoperative hearing loss and facial nerve palsy occurred in early MFA operation cases. With respect to facial nerve function, the MF approach group had a higher rate of development of facial neuropathy than did the TL approach group. Conclusion:We think patients with vertigo and tinnitus will progress to hearing loss. We should suspect IMVS if patients com-plain of vertigo and tinnitus. But, further evaluation should be needed. If postoperative hearing preservation is not important, the To use the MFA method, otolaryngologic surgeons need more direct and indirect experiences, considering the low incidence of acoustic schwannoma surgery and that the MFA method requires longer mean operation time than TLA. (Korean J Otolaryngol 2007 ;50 :203-8)


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Vestibular schwannoma· Caloric tests· Magnetic resonance imaging· Translabyrinthine· Middle cranial fossa.