Intradural Anterior Petrosectomy for Petroclival Meningiomas

Background: Excision of petroclival meningiomas remains a surgical challenge. Extradural anterior petrosectomy is used as one of the skull base approaches for these tumors. However, this approach has significant procedure-related morbidity.

Material and Methods: We describe an alternative technique of a tailored intradural petrosectomy combined with a fronto-orbito-zygomatic craniotomy for removal of petroclival meningiomas.

Results: Gross total excision was achieved in most of the patients without significant morbidity. The petrous drilling was tailored depending on the extent of tumor.

Conclusion: A trans-sylvian intradural anterior petrosectomy provides excellent exposure for petroclival meningiomas. This approach avoids problems related to subtemporal retraction and rationalizes the degree of bone drilling.