BACKGROUND AND OBJECTIVES The labyrinthine structures obstruct the surgical view of the deep petroclival region in the transpetrosal approach. Historically, labyrinthectomy and removal of all 3 semicircular canals, with resultant deafness, was used in patients with ipsilateral functional hearing deficits to improve access. The advent and systematization of superior and posterior semicircular canal removal (transcrusal approach) with good rates of hearing preservation has allowed a redefinition of the possibility of partial labyrinthectomy in patients without previous hearing deficits. The present manuscript is intended to describe a technical refinement of partial labyrinthectomy during focal combined petrosectomy, offering a customization of the approach through the selective removal of the superior semicircular canal for specific types of tumors. METHODS The use of the technique is demonstrated through surgical drawings, pictures, and videos. The rationale to indicate this new approach is discussed based on clinical cases. RESULTS Three illustrative clinical cases (petroclival meningiomas) are demonstrated. Functional hearing on the approach side has been preserved in all of them. CONCLUSION The focal combined transpetrosal approach associated with the superior semicircular canal resection has been a promising surgical technique in the treatment of selected petroclival tumors. It has the potential to further decrease the risks of postoperative auditory and vestibular dysfunctions associated with labyrinthectomies.

中文翻译：

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局灶联合经岩骨入路中仅限于上半规管的部分迷路切除：描述和说明性病例。

背景和目的 迷宫式结构阻碍了经岩骨入路中岩斜深部区域的手术视野。历史上，迷路切除术和所有 3 个半规管切除术（导致耳聋）被用于同侧功能性听力缺陷的患者，以改善通路。上半规管和后半规管切除术（经皮入路）的出现和系统化具有良好的听力保留率，这使得重新定义了对既往没有听力缺陷的患者进行部分迷路切除术的可能性。本手稿旨在描述局灶性联合岩骨切除术期间部分迷路切除术的技术改进，通过针对特定类型的肿瘤选择性切除上半规管来提供定制的方法。方法 通过手术图纸、图片和视频来演示该技术的使用。根据临床病例讨论了这种新方法的基本原理。结果 展示了三个说明性的临床病例（岩斜坡脑膜瘤）。所有这些都保留了接近侧的功能性听力。结论 局灶联合经岩骨入路联合上半规管切除术是治疗特定岩斜肿瘤的一种有前途的手术技术。它有可能进一步降低与迷路切除术相关的术后听觉和前庭功能障碍的风险。