Combined petrosal approach for a huge retroclival meningioma preserving the cranial nerves

Surgery for petroclival meningioma is challenging because cranial nerve preservation during tumor removal can be very complex. For small- to medium-sized tumors, the anatomical relationship between tumor and neurovascular structures can be assessed before surgery. However, in large tumors, cranial nerves usually cannot be seen in preoperative images. The authors present a case of a 65-year-old woman who presented with gait disturbance and hearing loss and was diagnosed with huge retroclival meningioma involving the cavernous sinus, Meckel’s cave, and internal acoustic meatus. In this video, they explain the radiographical, anatomical, and surgical considerations and demonstrate the surgical technique. The video can be found here: https://stream.cadmore.media/r10.3171/2022.1.FOCVID21221