Endoscopic transorbital approach for left anterior clinoidectomy, optic canal decompression and spheno-orbital meningioma resection

Endoscopic transorbital approaches have been increasingly used to treat lesions of the middle fossa, such as sphenoid wing meningiomas or cavernous sinus disease, eschewing the cosmetic and functional consequences of a frontotemporal craniotomy, as well as technical shortcomings of endoscopic endonasal approaches. In this video, the authors present a case of a spheno-orbital meningioma for which an endoscopic transorbital approach was used for tumor resection, optic canal decompression, and anterior clinoidectomy. The advantages of this approach are demonstrated, particularly the direct, shorter distance to target along the axis of the middle fossa, which avoids neurovascular structures, brain retraction, and temporal muscle manipulation. The video can be found here: https://stream.cadmore.media/r10.3171/2025.1.FOCVID24199.