Combined microsurgical and endoscopic lateral transorbital keyhole approach for Meckel’s cavity meningioma in a child: A clinical case and technical aspects

Background. Meckel’s cavity meningiomas in children are a rare pathology and present significant challenges for surgical treatment due to their deep tumor location and proximity to critical neurovascular structures. Dumbbell-shaped tumors extending into the middle and posterior cranial fossae pose particular challenges.

The aim of the study. To evaluate the feasibility of a combined microsurgical and endoscopic lateral transorbital keyhole approach for the removal of a dumbbell-shaped Meckel’s cavity meningioma in a child.

Materials and methods. A clinical case of a 13-year-old patient with a dumbbell-shaped Meckel’s cavity tumor extending into the right middle cranial fossa and cerebellopontine angle is presented. Surgical removal of the tumor was performed using a modified lateral transorbital approach with endoscopic assistance. Neurological status, neuroimaging data, intraoperative features, and long-term treatment outcomes were assessed.

Results. Total tumor resection was achieved, as confirmed by postoperative neuroimaging data. In the early postoperative period, regression of cerebellar symptoms was noted, with persistent transient paresis of the sixth cranial nerve and facial hypoesthesia. A 12-month follow-up revealed restoration of oculomotor function, no signs of recurrence, and a satisfactory cosmetic outcome.

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