The middle fossa approach for malignant tumors involving the petrous apex is discussed. A comprehension of the middle fossa anatomy is essential to navigate this approach. Careful, meticulous dissection is used to identify anatomic landmarks in order to prevent unnecessary injury and morbidity. The patient evaluation and diagnostic imaging are discussed. The operative procedure is illustrated and described in detail. Postoperative management and complications are explained. Postoperative radiotherapy is indicated for subtotal resection and grade II and higher chondrosarcomas.
KeywordsMiddle fossa Temporal bone cancer Chondrosarcoma Proton beam