Combined Extended Middle Cranial Fossa and Retrosigmoid Approaches for a Large Posterior Fossa Epidermoid

Posterior fossa pathology has the potential to involve multiple disparate anatomic locations, making the selection of approach difficult in large, complex pathology. Presented with an extensive epidermoid that involved multiple distinct and critical locations within the posterior fossa, spanning from the basilar artery to the jugular foramen, the authors elected to proceed with a combined extended middle cranial fossa and retrosigmoid approach to provide the requisite anterior and inferior exposure required to manage this pathology.