Objective: to describe two skull base approaches for petroclival meningiomas, defined as tumors arising from the upper two thirds of the clivus, at the petroclival junction, and medial to the trigeminal. Material and Method: the cranio-orbito-zigomatic approach (COZ), and the petrosal approach are described, being the internal auditory canal, the inferior extensión of the COZ approach. Conclusion: Skull base approaches are more suitable for radical removal of petroclival meningiomas. Soft tumors such as trigeminal schwannoma or epidermoid cyst or meningioma with extension into the petroclival region, but without attachment thereto, can be removed by retrosigmoid approach.

Objetivo. Describir dos abordajes a la base de cráneo para el tratamiento quirúrgico de meningiomas petroclivales, que son aquellos que se originan en los dos tercios superiores del clivus, en la unión petroclival, y mediales al nervio trigémino. Material y método. Se describen el abordaje cráneo-órbito-zigomático y el abordaje petroso posterior. Conclusión. Los abordajes en base de cráneo son de elección para la exéresis total de los meningiomas petroclivales. Los tumores blandos como los schwannomas trigeminales, los quistes epidermoides y los meningiomas con extensión a la región petroclival, pero sin inserción en la misma, pueden ser removidos por medio del abordaje retrosigmoideo.

Relatamos o caso de uma paciente de 43 anos com história de cefaléia crônica e diplopia. O exame neurorradiológico demonstrou aumento de volume e alteração na densidade óssea do clivus. Foi submetida a cirurgia e o exame anatomopatológico evidenciou displasia fibrosa. Foram relatados na literatura outros 14 casos de displasia fibrosa envolvendo o clivus. Discutimos essa rara apresentação da doença segundo o quadro clínico, exames de imagem, histologia e tratamento.

We describe the case of a 43 year-old woman with chronic headache and diplopia. The neurorradiologic exam showed volume increase and alteration in the bone density of the clivus. She was submitted to surgery and the anatomopathologic evidenced fibrous dysplasia. Other 14 of about fibrous dysplasia involving the clivus are related in the literature. We discuss clinical aspects, image exams, histology and treatment of this rare presentation of the disease.