{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T17:58:02Z","timestamp":1786125482764,"version":"build-2736575974"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T00:00:00Z","timestamp":1589155200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Skull base epidermoid tumors, meningiomas, and schwannomas can be accessed by different techniques depending on the location and size of the lesion. Small lesions located anterior to the internal acoustic meatus (IAM) can be accessed via the subtemporal approach, and lesions located posterior to the IAM can be approached via retrosigmoid craniotomy. However, expansive lesions that are located anterior to the IAM and extend posteriorly toward the lower clivus can be accessed via the petrosal approach. The petrosal approach (presigmoid-retrolabyrinthine) is centered on the petrous ridge of the temporal bone and is mainly performed for intradural lesions located at the clivus and petroclivus junction area. Patients with intact hearing can benefit from this technique, as the labyrinth is untouched and yet the middle and posterior fossa compartments are connected. Additionally, extension of the lesion from the suprasellar area\/cavernous sinus to the foramen magnum can be dissected and removed. There are variations of the petrosal approach, such as translabyrinthine, transotic, and transchoclear, with which hearing cannot be preserved, and the \u201ctranscrusal\u201d approach, wherein posterior and superior semicircular canals are sacrificed yet hearing preserved. The endolymphatic duct is usually transected and not reapproximated. Neurotology input is always helpful when dealing with inner ear structures.<\/jats:p>\n                  <jats:p>\n                    This complex approach demands exhaustive practice with temporal bone dissection in a cadaver laboratory. Although this approach can be extended anteriorly, combination with an anterior petrosal approach permits more rostral exposure. In this video, we demonstrate the stepwise dissection of the posterior petrosal approach only, showing procedure nuances in a cadaver.\n                    <jats:sup>1-8<\/jats:sup>\n                    <jats:italic toggle=\"yes\">Used with permission from Barrow Neurological Institute, Phoenix, Arizona<\/jats:italic>\n                    .\n                  <\/jats:p>","DOI":"10.1093\/ons\/opaa117","type":"journal-article","created":{"date-parts":[[2020,5,11]],"date-time":"2020-05-11T23:31:22Z","timestamp":1589239882000},"page":"E398-E399","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":3,"title":["Dissection of the Petrosal Presigmoid-Retrolabyrinthine Approach for the Petroclival Region on a Cadaver: 2-Dimensional Operative Video"],"prefix":"10.1227","volume":"19","author":[{"given":"Leandro","family":"Borba Moreira","sequence":"first","affiliation":[{"name":"The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Tayebi Meybodi","sequence":"additional","affiliation":[{"name":"The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochun","family":"Zhao","sequence":"additional","affiliation":[{"name":"The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaith K","family":"Almefty","sequence":"additional","affiliation":[{"name":"The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael T","family":"Lawton","sequence":"additional","affiliation":[{"name":"The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark C","family":"Preul","sequence":"additional","affiliation":[{"name":"The Loyal and Edith Davis Neurosurgical Research Laboratory, Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,10]]},"reference":[{"issue":"1","key":"bib1-20240909","first-page":"139","article-title":"Petroclival meningiomas: predictive parameters for transpetrosal approaches","volume":"47","author":"Abdel Aziz","year":"2000","journal-title":"Neurosurgery"},{"issue":"2","key":"bib2-20240909","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/S1092-440X(99)80011-5","article-title":"The petrosal approach","volume":"2","author":"Abdulrauf","year":"1999","journal-title":"Oper Tech Neurosurg"},{"issue":"3","key":"bib4-20240909","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1227\/00006123-198803000-00010","article-title":"Petrosal approach for petroclival meningiomas","volume":"22","author":"Al-Mefty","year":"1988","journal-title":"Neurosurgery"},{"issue":"5 Suppl 2","key":"bib5-20240909","first-page":"202","article-title":"Evolution of surgical approaches in the treatment of petroclival meningiomas: a retrospective review","volume":"61","author":"Bambakidis","year":"2007","journal-title":"Neurosurgery"},{"issue":"3","key":"bib6-20240909","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1097\/00006123-200209000-00017","article-title":"Combined petrosal approach to petroclival meningiomas","volume":"51","author":"Cho","year":"2002","journal-title":"Neurosurgery"},{"issue":"2","key":"bib7-20240909","doi-asserted-by":"crossref","first-page":"E7","DOI":"10.3171\/foc.2005.19.2.8","article-title":"Surgical management of petroclival meningiomas: factors determining the choice of approach","volume":"19","author":"Erkmen","year":"2005","journal-title":"Neurosurg Focus"},{"issue":"4","key":"bib8-20240909","doi-asserted-by":"crossref","first-page":"508","DOI":"10.3171\/jns.1993.79.4.0508","article-title":"The petrosal approach with hearing preservation","volume":"79","author":"King","year":"1993","journal-title":"J Neurosurg"}],"container-title":["Operative Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ons\/article-pdf\/19\/4\/E398\/33919417\/opaa117.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opaa117","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:56:17Z","timestamp":1786121777000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.1093\/ons\/opaa117"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,11]]},"references-count":7,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.1093\/ons\/opaa117","relation":{},"ISSN":["2332-4252","2332-4260"],"issn-type":[{"value":"2332-4252","type":"print"},{"value":"2332-4260","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,11]]},"assertion":[{"value":"2019-08-29","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-03-14","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}