Endoscope-Assisted Microsurgery in Petroclival Meningioma Combined with Contralateral Trigeminal Schwannoma

Objectives: To introduce a rare case of bilaterally developed skull base tumor and surgical tactics to remove the mass with endoscope assistant. Patient: A 46-year-old female patient presented with facial numbness for 2 months. She showed decreased facial sensory change and pterygoid muscle weakness. Brain magnetic resonance image (MRI) revealed round well demarcating mass on left petroclival area. The size was 4 × 5cm, extending from the internal acoustic canal to the midbrain. It showed well homogenous enhancement and dural tail sign. There was another mass on the contralateral infratemporal fossa. It originates from Meckels cavum and extends to the infratemporal fossa. Digital subtraction angiography revealed rare vascularization around both the tumors. Result: Anterior petrosal approach was done to the petroclival mass. Invisible site with microscope was examined with endoscope. Total removal was done without any complication. Pathology report was meningioma. Subtemporal approach was performed instead of usual infratemporal fossa approach with the aid of endoscope, which provides a nice view about the invisible site with a microscope. Conclusion: We could successfully remove benign skull base tumors with the aid of endoscope by minimal-invasive approach.