TRANSPETROSAL ACCESS TO MENINGIOMAS JUXTAPOSING THE TEMPORAL BONE

Meningiomas arising from the petroclival dura have presented a challen ge to both otolaryngologists and neurosurgeons. Access by means of sub temporal, suboccipital, translabyrinthine, or transcochlear routes hav e inherent limitations both surgically as well as from resultant morbi dity. Since 1988, the authors have used a transpetrosal transtentorial (combined sabtemporal suboccipital presigmoid) approach to these lesi ons in selected cases. The goals of this technique have been to preser ve function of the cranial nerves, to avoid excessive retraction of th e temporal lobe and cerebellum, and to eliminate damage to the venous sinus and Labbes vein. Exposure of the base of the tumor for ablation of the blood supply and access for tumor removal is an important advan tage of this approach.