Modified Dolenc-Kawase anterior petrous rhomboid approach for petroclival meningioma: surgical nuances and complication avoidance

Abstract

Resection of petroclival meningiomas has remained challenging because of the critical neurovascular structures that lie in the vicinity, and thus various surgical corridors have been explored over time to figure out the optimum approach. In this video, the authors have highlighted the operative nuances of the modified Dolenc-Kawase (MDK) anterior petrous rhomboid approach. This approach gives access to the prepontine area, Dorello’s canal, anterior petrous apex, and upper two-thirds of the clivus with better angulation and surgical flexibility. It is a versatile approach for petroclival lesions that are not extending laterally and inferiorly to the internal auditory canal. The video can be found here: https://stream.cadmore.media/r10.3171/2022.1.FOCVID21256