Introduction: Petrosal apex meningiomas are defined as tumors originating in the petrous angle and which may extend anteriorly, extending from the infratemporal region to the petroclival region. Total resection of petrous apex tumors has been considered to carry a high risk of mortality and neurological sequelae. We present the first case performed at the Hospital Nacional PNP Luis N. Sáenz using a combined pretemporal and subtemporal approach for petrous apex meningiomas projecting to the infratemporal fossa and petroclival region.

Case Report: A 55-year-old male patient with no medical history presented with a 2-year history of headache, bitemporal hemianopia, tinnitus, and paresthesias on the left side of the face. A combined half-and-half pretemporal and subtemporal approach with an infratemporal fossa projection was performed, achieving complete tumor resection and preservation of cranial nerve function, without intraoperative complications. The patient progressed favorably without a significant neurological deficit and was discharged on the 8th day.

Conclusion: The combined half-and-half pretemporal and subtemporal approach with an infratemporal fossa projection for meningiomas arising in the petrous apex with extra-axial and intradural projection and extending into the petroclival region is an effective option for the resection of highly complex tumors.

       Keywords: Meningioma, Petrous Bone, Hemianopsia, Infratemporal Fossa. (Source: MeSH NLM)