Anterior transpetrosal approach for a recurrent craniopharyngioma in a pediatric patient: two-dimensional operative video

Abstract

The authors present the case of a 13-year-old patient with a recurrent cystic lesion extending into the lateral pons. A right frontotemporal craniotomy with zygomatic osteotomy and an anterior transpetrosal approach, including extradural middle fossa peeling, Kawase’s triangle petrosectomy, and transtentorial extension, provided a lateral trajectory to the brainstem. Microsurgical dissection allowed safe separation of the lesion from the superior cerebellar artery, trigeminal rootlets, and pontine surface, achieving gross-total resection. This case highlights key technical nuances of anterior transpetrosal surgery for recurrent skull base craniopharyngioma with pontine invasion. The video can be found here: https://stream.cadmore.media/r10.3171/2026.7.FOCVID26128