Background The transcrusal approach that involves partial removal of the labyrinth was recently described to approach lesions of the cerebellopontine angle. It carries the benefit of hearing preservation and was suggested to have equivalent exposure of the petroclival surface compared with the transcochlear/transotic approaches. The current study was designed to assess if the transcrusal approach could achieve as good access to the internal auditory meatus (IAM) as the more destructive translabyrinthine exposure. Methods Fifty disease-free high-resolution computed tomography scans of the temporal bone were reviewed. Surgical freedom, angle of attack, and angle of trajectory to the internal acoustic canal were measured in three-dimensional models. Results Surgical freedom and angles of attack showed steady increments with the progression of petrous bone resection from the retrolabyrinthine-transcrusal-translabyrinthine approaches. The angle of access to the IAM axis was dramatically reduced in the translabyrinthine approach compared with the transcrusal and retrolabyrinthine approaches (37.51 ± 5.7, 24.56 ± 4.6, and 3.17 ± 2.85 degrees, respectively; n = 50; average plus or minus standard deviation, p
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机译：背景：最近描述了涉及部分切除迷宫的经颅入路治疗小脑桥脑角病变。它具有听力保护的优势，并且建议与经耳蜗/经耳穿刺方法相比，其对石斜坡表面的暴露程度相同。当前的研究旨在评估经颅方法是否可以像破坏性更大的经迷宫式暴露一样获得良好的内耳道（IAM）通路。方法：对颞骨进行了五十次无疾病的高分辨率计算机断层扫描。在三维模型中测量手术的自由度，迎角和与内耳道的轨迹角。结果手术后自由度和攻角随着后路迷路-经颅-经路迷路入路的岩性骨切除的进展呈稳定增长。与经颅和后迷路入路相比，经迷路入路与IAM轴的接触角显着减小（分别为37.51±5.7、24.56±4.6和3.17±2.85度； n == 50；平均正负标准差， p
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