How I do it: retrosigmoid intradural inframeatal petrosectomy

BACKGROUND: Lesions infiltrating the petrous temporal bone are some of the most complex to treat surgically. Many approaches have been developed in order to address these lesions, including endoscopic endonasal, anterior petrosectomy, posterior petrosectomy, and retrosigmoid. METHOD: We describe in a stepwise fashion the surgical steps of the retrosigmoid intradural inframeatal petrosectomy. CONCLUSION: The retrosigmoid intradural inframeatal petrosectomy may afford satisfactory exposure with limited drilling and minimal disruption of perilesional anatomical structures. It can provide excellent surgical results, especially for soft tumors, while minimizing surgical morbidity. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00701-020-04587-0) contains supplementary material, which is available to authorized users.