This 46-year-old female presented with progressive hearing loss in the left ear. The MR imaging revealed an intra-extrameatal vestibular schwannoma extending laterally into the fundus of the internal auditory canal. Preoperatively, the patient's useful hearing was classified as grade I on the Gardner and Robertson scale.
The operation was performed via a middle retrosigmoid approach. The patient is supine with the head tilted to the right.
The postoperative CT scan on the day after the operation shows the extent of the drilling of the posterior wall of the internal auditory canal with preserved vestibule and semicircular canals. The MR images taken 3 months after surgery show the complete removal of the tumor. The patient displays normal facial nerve function and preserved functional hearing (class I according to Gardner and Robertson).