title: The epidural approach to the Meckel's cave: a how I do it.
abstract: BACKGROUND
  Meckel's cave (MC) is a meningeal cleft lying in the middle fossa laterally to the cavernous sinus. Tumours that develop inside the MC may require a surgical resection. The authors describe the surgical technique of the intracranial epidural approach to the MC.
  
  
  METHODS
  Based upon anatomical dissection showing the relevant surgical anatomy, and illustrated by the video of an operated case, the authors detail the surgical procedure. The key point is to shave the floor of the middle fossa and skeletonize the superior orbital fissure, rotundum and ovale foramen in order to delineate the plane of dural elevation and expose the lateral wall of the MC. The rules of exposure and resection of the tumour are then shown. Variations and limitations of the approach are discussed.
  
  
  CONCLUSIONS
  Conducted in a stepwise manner and following relevant landmarks, the epidural anterolateral approach offers a safe and reliable exposure to the diseases that develop within the MC.
authors.affiliation: Service de Neurochirurgie, Hôpital Nord, APHM, University Hospital of Marseille Aix-Marseille Univ, Marseille, France, proche@ap-hm.fr.
authors.forename: Pierre-Hugues
authors.initials: PH
authors.lastname: Roche
authors.forename: Lucas
authors.initials: L
authors.lastname: Troude
authors.forename: Hadrien
authors.initials: H
authors.lastname: Peyriere
authors.forename: Rémy
authors.initials: R
authors.lastname: Noudel
mesh_terms: D002426:Cavernous Sinus / Q000473:pathology / Q000601:surgery*; D004388:Dura Mater / Q000473:pathology / Q000601:surgery*; D054085:Foramen Ovale / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008866:Microsurgery; D019635:Neurosurgical Procedures / Q000379:methods; D016896:Treatment Outcome