Anterior Transpetrosal Approach for Petroclival Meningioma: Operative Nuances

Petroclival meningiomas are unique neurosurgical challenges that require planning an approach to the retrosellar and upper and mid retroclival locations. The classical subtemporal-transtentorial approach went into disrepute due to excessive brain retraction. To resolve this challenge Buchenek and Kukwa introduced extradural approach with drilling of the petrous bone and called it the extended middle fossa approach. It was Kawase et al who modified the extended middle fossa approach initially for dealing with basilar trunk aneurysms. This anterior transpetrosal approach has been described below for dealing with the petroclival meningiomas.