See the picture of surgery-Auditory neuroma

      Abrasion of the internal auditory canal” is a very important part of auditory neuroma surgery, which is the removal of the internal auditory canal to reveal the tumor. We present the steps and details of the endo-aural tract debridement by listing screenshots from a surgical video of an auditory neuroma case.         This is a case of a 30-year-old male patient who presented with hearing loss on the left side starting at the age of 12 years and progressively deteriorated until complete loss. Because the tumor was located deep in the internal auditory canal and was small in size, it should have been suitable for radiosurgery because of the hearing loss, but the patient himself strongly requested surgical resection for treatment.        Before surgery, it is important to understand the relevant bony structures of the internal auditory canal in great detail and to carefully measure the distance between the cochlea, the semicircular canal and the opening of the internal auditory canal. Because of the more medial location of the airspace of the internal auditory canal, the internal auditory canal must be open when it is abraded, so that muscle tamponade and bioprotein adhesive fixation are required after tumor removal to prevent cerebrospinal fluid leakage.         After exposing the inner opening of the internal auditory canal, the dura mater behind the internal auditory canal is cut in “H” shape, and the lateral side is not more than 1cm away from the internal auditory foramen. First, the upper wall of the internal auditory canal is ground with a high-speed grinding drill (flower drill).         When grinding away the bone of the internal auditory canal, the scope should be slightly wider, and it is important not to form a groove by repeated grinding confined to one place. Pry the bone above the internal auditory canal At this point, a high-speed grinding drill (flower drill) has been used to complete the grinding of the bone on one side of the internal auditory canal When grinding below, care should be taken to avoid the jugular vein bulb. At this point, the diamond drill needs to be used with constant flushing to avoid damaging the jugular bulb.         The facial nerve is often located anteriorly and inferiorly to the dural sac, and care should be taken to avoid damage to the facial nerve when grinding from above. The standard for the extent of abrasion should be that the dural sac of the tumor is exposed more than 180°.         The extent of lateral grinding of the internal auditory canal should be based on preoperative CT. If, however, the procedure can be performed with the assistance of neuroendoscopy, the extent of grinding does not usually have to exceed 1 cm. After completing the grinding of the bones of the internal auditory canal, the dural sac of the tumor in the internal auditory canal is opened.