Table 5.

Pros and cons for each corridor for the management of cavernous sinus meningiomas (CSM).

Corridor	Pros	Cons
Lateral Route
Anterior petrosectomy	Acceptable surgical freedom on MCF, MC, upper third of the clivus and ventral brainstem	Inadequate bony window for accessing PCF
Posterior petrosectomy	Broad view of the middle clivus Pregasserian and retrogasserian corridors Visualization of CNs from brainstem to CS Extended view over the posterior fossa	The greater the exposure the greater the risk of hearing loss and facial damage Wide exposure and manipulation of the sigmoid sinus Inadequate control of tumor extending into the MCF
Combined transpetrosal	Exploited for lesions spanning both middle and posterior cranial fossae	-
Anterolateral Route
Extended pterional + extradural anterior clinoidectomy	Early unroofing of the optic nerve Early CSF release Extradural exposure of the CS	Inadequate control of tumor extending into the PCF
Fronto-temporo-orbito-zygomatic approach + extradural anterior clinoidectomy	High surgical freedom Larger exposure of lesions involving the middle fossa and adjacent areas Less brain retraction	Inadequate control of tumor extending into the PCF
Pretemporal trans-cavernous trans-Meckel’s trans-tentorial trans-petrosal	Satisfactory control of the PCF and precavernous course of CNs Good control of both supra and infra tentorial lesion	-
Ventral Route
Extended endoscopic endonasal transsphenoidal Endonasal transethmoidal/transsphenoidal (far lateral) Contralateral endoscopic endonasal transsphenoidal approach	Direct visualization over the bony prominences of neurovascular structures Lesions can be followed via the thin medial wall of the CS Early pituitary gland decompression Direct infero-medial decompression of the optic canal Low risk of CSF leak	Low GTR rate

CSF: cerebrospinal fluid; MCF: middle cranial fossa; PCF: posterior cranial fossa; MC: Meckel’s Cave; ICA: internal carotid artery; CS: cavernous sinus; CNs: cranial nerves.