Anatomy and Variation for Combined Transpetrosal Approach

Surgical excision of tumors involving the petroclival region has a technical challenge, mainly due to access, especially for their relationship with the brain stem, cranial nerve, temporal lobe, and blood vessels. The anterior and posterior combined transpetrosal approach is usually advantageous for minimizing temporal lobe retraction, thereby allowing access to the ventral brainstem and permitting the removal of petroclival lesions. In this chapter, we provide details and variations of the anterior and posterior combined transpetrosal approach, which is expected to have a major advantage for skull base lesions.