The Suboccipital Transtentorial Approach: Indications, Technique, and Outcomes in Five Illustrative Cases

Abstract

Introduction: The suboccipital retrosigmoid approach is an effective alternative to transpetrosal approaches to petroclival meningiomas. Samii modified this with a retrosigmoid intradural suprameatal approach to increase access to the middle fossa and Meckel's cave. More recently, Watanabe et al modified this by preferentially dividing the tentorium with limited drilling of the suprameatal bone, which they termed the “lateral supracerebellar transtentorial approach.” Poppen introduced sectioning of the tentorium via an occipital approach for pineal region pathology. We present our experience with a suboccipital transtentorial approach.