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. 2022 Apr 1;6(2):V5.
doi: 10.3171/2022.1.FOCVID21258. eCollection 2022 Apr.

Extended middle fossa approach for resection of a petroclival meningioma and vestibular schwannoma

Robert C Rennert  1 , Karol P Budohoski  1 , Richard K Gurgel  2 , William T Couldwell  1
Affiliations

Extended middle fossa approach for resection of a petroclival meningioma and vestibular schwannoma

Robert C Rennert et al. Neurosurg Focus Video. .

Abstract

A 69-year-old woman with refractory left facial pain and subtle left hearing decline had a 13.0 × 8.1-mm left petrous apex/Meckel's cave meningioma and an 8.8 × 5.6-mm left intracanalicular vestibular schwannoma. She was otherwise neurologically intact. The anterior petrous and middle fossa approaches provide ideal access to these lesions individually, so an extended middle fossa approach was used to resect both in the same setting. She was neurologically stable postoperatively, except for a transient abducens palsy. Hearing was preserved on audiogram, and 4-month MRI displayed no tumors. The extended middle fossa approach provides excellent exposure of the petrous apex and internal auditory canal. The video can be found here: https://stream.cadmore.media/r10.3171/2022.1.FOCVID21258.

Keywords: extended middle fossa; petroclival meningioma; resection; vestibular schwannoma.

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Conflict of interest statement

Disclosures Dr. Gurgel reports grants from NIH/NIA, Advanced Bionics, and Cochlear LLC; and personal fees from Med-El, outside the submitted work. No other disclosures were reported.Dr. Gurgel reports grants from NIH/NIA, Advanced Bionics, and Cochlear LLC; and personal fees from Med-El, outside the submitted work. No other disclosures were reported.

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