Endoscopic lateral transorbital approach for resection of a middle fossa meningioma

The lateral transorbital approach (LTOA) is useful for lesions situated in the middle fossa, adjacent to the lateral wall of the cavernous sinus, as it minimizes brain retraction and provides an extradural corridor. In this video, the authors present the case of a 35-year-old male, complaining of headache and diplopia. MRI revealed a dural-based middle fossa lesion adjacent to the lateral wall of the cavernous sinus. An endoscopic LTOA was performed through a superior eyelid incision. Postoperative MRI showed minimal residual enhancement, and histopathological analysis reported a grade III anaplastic meningioma. The patient was discharged after 48 hours without a new neurological deficit. The video can be found here: https://stream.cadmore.media/r10.3171/2025.1.FOCVID24176.