Acta Neurochirurgica · Published 2026-06-11 · DOI 10.1007/s00701-026-06941-0
Yen-Yu Lin, Chien-Fu Yeh, Ming-Ying Lan, Wei-Hsin Wang
Abstract Background Surgical management of ventral foramen magnum meningiomas (FMMs) is challenging due to intervening neurovascular structures. The endoscopic endonasal transclival approach provides a direct access, offering a potential route to achieve Simpson Grade 1 resection while minimizing brainstem retraction. Method We detail the technical nuances of a binostril, four-handed EEA for a ventral FMM. We explain the key anatomical landmarks required for safe decompression, including clival drilling limits, the identification of pre-medullary neurovascular structures, and the execution of a multilayered reconstruction. Conclusion The EEA is a safe alternative for ventral FMMs in cases without significant lateral or caudal extension.
Abstract from DOAJ. Public domain (CC0 1.0).
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Lin, Y., Yeh, C., Lan, M., et al. (2026). How I do it: endoscopic endonasal transclival resection of ventral foramen magnum meningioma. Acta Neurochirurgica. https://doi.org/10.1007/s00701-026-06941-0