The transcochlear exposures represent a spectrum of three approaches (
transotic to transcochlear to transpetrous) that provide progressively
wider lateral skull base exposure. The approaches all combine the tra
nslabyrinthine approach with removal of the cochlea. The facial nerve
remains in situ in the transotic approach. The facial nerve is mobiliz
ed posteriorly in the transcochlear approach, and the transpetrous exp
osure adds resection of the petrous apex with carotid artery mobilizat
ion. This report focuses on the indications for each of the variations
of transcochlear exposure. These lateral skull base exposures can be
individualized to the needs of each patient.