Temporal Bone: Posterior Petrosectomy

The transpetrosal approach was initially used for better access to cerebellopontine angle tumors, around the petroclival and posterior cavernous sinus regions, anterior brainstem, or for basilar artery lesions. Petroclival lesions are the most challenging and include meningiomas, neurinomas, chordomas, chondrosarcomas, epidermoids, cavernomas, arteriovenous malformations, and basilar trunk aneurysms. Various approaches were developed for this region but it is the retrosigmoid approach and the combined transpetrosal approach the ones that are indicated for the majority of cases, the latter even allowing a more extensive and direct exposure of large petroclival lesions with supra and infratentorial extension, most frequently petroclival meningiomas, it allowed a more extensive and direct exposure of large petroclival lesions with supra and infratentorial extension, most frequently petroclival meningiomas.