Transpetrosal and combination approaches to skull base lesions

Petrosectomy is the essential component of many of the important skull base approaches. The transpetrosal approaches enable safe surgical treatment of many petroclival lesions. The combination approaches further increase surgical exposure for more complex lesions. Selecting the best surgical approach requires careful evaluation of lesion location, size, pathology, and the patient's preoperative neurological function. Successful management of these difficult lesions requires a multidisciplinary team that is critically dependent on the neuro-otologist.