Combined petrosal approach for resection of a large left petroclival meningioma.

Neurosurgical focus: Video(2022)

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Abstract
Petroclival meningiomas represent the most complex lesions in skull base surgery, being closely related to critical neurovascular structures. The combined petrosal approach allows a wide exposure of the petroclival region and provides multiple angles of attack, limiting brain retraction. The authors present the case of a 54-year-old man with a large left petroclival meningioma responsible for headaches, dysphagia, and trigeminal neuralgia. The lesion was resected using a combined petrosal approach. A progressive improvement of the preoperative symptoms was observed. Postoperative MRI showed a near-total resection of the tumor, along with reexpansion of the brainstem. The video can be found here: https://stream.cadmore.media/r10.3171/2022.1.FOCVID21226.
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Key words
Labbé vein,combined petrosal approach,cosmetic mastoidectomy,petroclival meningioma,semicircular canals,superior petrosal sinus,tentorial cutting,transverse-sigmoid junction
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