Unit of Neurosurgery, San Filippo Neri Hospital, ASL Roma1, Italy; Department of Neurosurgery, The First Sechenov Moscow State Medical University under Ministry of Health, Russian Federation. Electronic address: [Email]
BACKGROUND : Skull base tumors arising from the middle cranial fossa and invading of the infratemporal fossa (ITF) and middle cranial fossa are challenging for neurosurgeons, due to complex anatomy, and critical neuro-vascular structure involvement. The first pioneering ITF approaches resulted in invasive procedures and carried an high rate of surgical morbidity. However, the acquisition of deep anatomical knowledge, and the development operative skills and reconstruction techniques allowed to achieve total or near total resection of many ITF lesions with a low morbidity rate. In this video we illustrate our technique for the anterior ITF approach for the surgical treatment of a middle cranial fossa meningioma invading the ITF. METHODS : This surgical video described the anterior ITF approach in two step. First, a standard extradural middle fossa approach subtemporal approach is performed on a cadaveric specimens, illustrating the anterior extension to the cavernous sinus. Second, the anterior ITF approach is performed for the surgical treatment of a temporal lobe meningioma with extension to the anterior ITF. CONCLUSIONS : This technique provides a minimally invasive approach for treating middle fossa lesions with anterior ITF extension.