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

## TL;DR

This paper describes a successful surgical technique for removing a specific type of brain tumor with minimal risk to surrounding nerves and blood vessels.

## Contribution

The paper presents a feasible method for achieving a complete tumor removal using EAC and dural peeling in a challenging tumor location.

## Key findings

- EAC and dural peeling allowed for a Simpson grade I resection of a sphenoid wing meningioma.
- The technique minimized the risk of neurovascular injury during surgery.
- Anatomical knowledge is crucial for safe dissection in this complex region.

## Abstract

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.

In a patient with a middle/inner ridge sphenoid wing meningioma, EAC and targeted dural peeling allowed for a Simpson grade I resection.

EAC and targeted dural peeling enable a feasible Simpson grade I resection of a middle/inner ridge sphenoid wing meningioma, while minimizing neurovascular injury.

The online version contains supplementary material available at 10.1007/s00701-025-06626-0.