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Al-Mefty, Ossama M.D.; Ayoubi, Samer M.D.; Kadri, Paulo A.S. M.D.

doi: 10.1227/01.neu.0000326015.76692.3d
TUMOR: Operative Nuances

THE PETROSAL (PRESIGMOID transtentorial) approach has been advocated for resecting retrochiasmatic craniopharyngiomas. The projection of the surgical corridor, posterior to anterior and inferior upward, is particularly valuable in dissecting the upper pole of the tumor, which projects high into the third ventricle. This approach allows direct visualization for dissecting the hypothalamus and the pituitary stalk, and maintaining their blood supply and functional integrity. With a web site video presentation, we demonstrate the operative nuances of the approach to these tumors. We recommend this approach for patients with large and giant retrochiasmatic craniopharyngiomas.

Department of Neurosurgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas (Al-Mefty)

Division of Neurosurgery, Alabama-Muwasat University Hospital, Damascus, Syria (Ayoubi)

Department of Neurosurgery, Federal University of Mato Grosso do Sul, Campo Grande, Brazil (Kadri)

Reprint requests: Ossama Al-Mefty, M.D., Department of Neurosurgery, University of Arkansas for Medical Sciences, 4301 West Markham, #507, Little Rock, AR 72205. Email:

Received, April 23, 2007.

Accepted, September 5, 2007.

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