Transotic Approach to the Cerebellopontine Angle

The transotic approach to the cerebellopontine angle has been developed at the University of Zurich for the removal of acoustic tumors in an effort to increase operative exposure and enhance facial nerve preservation and reconstruction. Key steps involve the total removal of all pneumatic cell tracts with middle ear and eustachian tube obliteration, followed by complete otic capsule removal for tumor exposure. This article discusses the advantages, disadvantages, and technique of this approach.