Nair, SGopalakrishnan, CVVikas, VAbraham, MRao, RMMenon, GGeorge, VEaswer, HVSudhir, JKAmit, D2017-03-102017-03-102012,;51-60https://dspace.sctimst.ac.in/handle/123456789/10217A retrospective analysis of 119 cases of petroclival-premeatal meningiomas surgically managed in their institute from 1st Jan 1990 till 14th November 2011 was carried out to see the outcome with various approaches. While the tumor resection was carried through an anterolateral/ lateral route in 32(27%), it was through a combined posterior subtemporal /pre or trans-sigmoid (posterior petrosal) in 24(20%) & retrosigmoid supra-paracerebellar route in 55 cases (46%). In three cases with extra cranial extension to infratemporal area, a modified Fisch approach was used. Five patients who were in poor clinical condition had only a CSF diversionary procedure. The percentage of these tumors operated by conventional retrosigmoid route has increased in the later part of the series thus proving that in many of these tumors without significant middle fossa extension, it is not necessary to use complex and time consuming skull base approaches which in themselves can cause morbidity. The tumor could be radically removed in 79 patients (66%), subtotally in 26 (22%) and decompression only in 9). Six patients had tumor excision in two stages. There was an operative mortality of 8.4% (10 cases). Out of the 85 patients on long term follow up 56 are independent. Six out of the eight patients who had symptomatic recurrence were re-operated.Neurosciences & Neurology; Surgery