Anterior tra nspetrosal and infratemporal approaches in surgery of neoplasms of sphenopetroclival localization

Introduction. Until recently, surgical treatment of sphenopetroclival tumors was considered impossible. With the advancement of microsurgery and the emergence of new technologies, tumors in this area have become amenable to  surgical treatment. However, surgical treatment of tumors in  this area remains one of  the most challenging areas of  skull base surgery due  to  the  proximity of  important vascular and neurovascular structures.
The  aim. To  describe and  analyze treatment outcomes and  surgical complications associated with the anterior transpetrosal and infratemporal approaches in surgery for sphenopetroclival tumors.
Materials and methods. The study group included 13 patients (8 women and 5 men; mean age 55 years) with  sphenopetroclival tumors, operated  on using the  anterior transpetrosal and  infratemporal approaches. Patients were divided into two groups. Group 1 consisted of 7 patients (4 women, 3 men) with  sphenopetroclival tumors who  were operated  on using an  anterior transpetrosal approach. Group 2 included 6 patients (4 women, 2 men) with sphenopetroclival tumors who were operated on using an infratemporal approach.
Results. In the group 1, total resection was achieved in 1 patient, subtotal resection  – in 5 patients, and partial resection – in 1 patient with chondrosarcoma. In the group 2, total resection was achieved in 2 patients, subtotal resection – in 3 patients, and partial resection – in 1 patient with sphenopetroclival meningioma.
Conclusion. Surgical treatment of sphenopetroclival tumors remains one of the most challenging areas of skull base surgery. Various lateral and posterior approaches, or combinations of these approaches, are  used for  resection of  tumors in  this location. These diff erent approaches have both advantages and  disadvantages. Understanding the  technical nuances and  anatomical basis of  each approach is crucial for choosing the optimal approach.

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