How I do it: Simpson grade I resection in a medial and inner ridge sphenoid wing meningioma

Background: Extradural anterior clinoidectomy (EAC) and dural peeling of the lateral wall of the cavernous sinus (CS) are challenging skull base techniques that enhance exposure to anterior and middle cranial fossa lesions. Intimate knowledge of dural anatomy enables safe dissection and identification of critical neurovascular structures without cranial nerve deficit postoperatively. Methods: In a patient with a middle/inner ridge sphenoid wing meningioma, EAC and targeted dural peeling allowed for a Simpson grade I resection. Conclusion: EAC and targeted dural peeling enable a feasible Simpson grade I resection of a middle/inner ridge sphenoid wing meningioma, while minimizing neurovascular injury.