The subtemporal-transpetrous approach for excision of petroclival tumors.

The subtemporal transpetrous approach to the petroclival region uses a combination of techniques, including a petrosectomy and a subtemporal and suboccipital craniotomy. Ligation of the greater petrosal sinus, sigmoid sinus, and retraction of the temporal lobe affords wide exposure to the petroclival region and ventral brainstem and minimizes the need for facial nerve translocation. This approach has been successfully used in the management of 10 large tumors of the region, including chondrosarcomas, chordomas, meningiomas, and schwannomas. The history and evolution of this technique and its relation to other similar approaches is discussed.