Full endoscopic endonasal suprapetrous approach to Meckel’s cave

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Meckel's cave is an anatomically complex region that can be approached surgically via several routes, namely the posterolateral, lateral, anterolateral, and, due to recent advancements, anteromedial routes, with the latter being represented by the expanded endonasal approaches.


We describe in detail the surgical technique of the suprapetrous endonasal approach to Meckel's cave and highlight the main anatomical key elements involved in this approach as well as the technical aspects for avoiding surgical complications.


The suprapetrous endonasal approach to Meckel's cave avoids the brain tissue retraction, and thereby prevents postoperative brain edema.

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    Kassam AB, Prevedello DM, Carrau RL, Snyderman CH, Thomas A, Gardner P, Zanation A, Duz B, Stefko ST, Byers K, Horowitz MB (2011) Endoscopic endonasal skull base surgery: analysis of complications in the authors' initial 800 patients. J Neurosurg 114(6):1544–1568

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    Roche PH, Troude L, Peyriere H, Noudel R (2014) The epidural approach to the Meckel's cave: a how I do it. Acta Neurochir (Wien) 156(1):217–220

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Correspondence to Juan Antonio Simal Julián.

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Simal Julián, J.A., Miranda Lloret, P., García Piñero, A. et al. Full endoscopic endonasal suprapetrous approach to Meckel’s cave. Acta Neurochir 156, 1623–1626 (2014) doi:10.1007/s00701-014-2113-x

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  • Endonasal
  • Endoscopic
  • Meckel’s cave
  • Suprapetrous