How I do it: combined petrosectomy

  • Shunya Hanakita
  • Kentaro Watanabe
  • Pierre-Olivier Champagne
  • Sébastien FroelichEmail author
How I Do it - Neurosurgery general
Part of the following topical collections:
  1. Neurosurgery general



Petroclival lesions are among the most complex to address in skull base surgery, being closely related to critical neurovascular structures and brainstem. The combined petrosectomy allows a wide exposure of large petroclival lesions with short working distance and provides multiple angles of attack, while limiting brain retraction.


We describe in a step-wise fashion the surgical steps of the combined petrosectomy.


Combined petrosectomy with posterior transposition of the transverse-sigmoid sinus provides a wide surgical corridor to the ventral brainstem, middle and upper clivus, and infra-retrochiasmatic region.


Anterior petrosectomy Combined petrosectomy Petroclival region Posterior petrosectomy Skull base surgery 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Patient consent

The patient has consented to the submission of this How I Do It for submission to the journal.

Supplementary material (263.3 mb)
Operative video demonstrating the major steps described in this work to perform the combined petrosectomy (MOV 269654 kb)


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  • Shunya Hanakita
    • 1
  • Kentaro Watanabe
    • 1
  • Pierre-Olivier Champagne
    • 1
  • Sébastien Froelich
    • 1
    Email author
  1. 1.Department of Neurosurgery, Lariboisière Hospital, Assistance Publique – Hôpitaux de ParisParis Diderot UniversityParisFrance

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