Pyramidal Approach with Partial Petrosectomy in Management of Petrous Apex Meningiomas and Other Petroclival Tumors

Abstract

Introduction: One of the varieties of posterolateral approaches to the petrous apex is the pyramidal approach. It is a combination of subtemporal and retrosigmoid accesses with partial petrosectomy, which is limited by facial nerve canal and labyrinth. The most frequent neoplasm in the region of the petrous apex is meningioma. In its slow growth it can penetrate the clival region, cerebellopontine angle, middle cranial fossa, and even invade cavernous sinus. In its advanced stages it becomes an interdisciplinary problem, requiring the cooperation of the neurosurgeon, ENT, and facial surgeon.