Mini-Pterional Approach to Anterior Cranial Fossa Meningiomas

Anterior cranial fossa meningiomas include those involving the planum sphenoidale, the olfactory groove, the clinoid, the tuberculum sellae, the suprasellar region, and the sphenoorbital skull base. The majority of these tumors involve both anterior and middle fossae. Although some of these locations may be accessed via an endonasal endoscopic approach or an eyebrow craniotomy, the open mini-pterional approach remains a workhorse for access to these pathologies. In this chapter, we outline the indications, anatomical considerations, and techniques for the safe and effective extirpation of anterior cranial fossa meningiomas using this robust approach.