Exo- and endoscopic two-step approach for anterior foramen magnum meningiomas: How I do it

Anterior foramen magnum (AFM) meningiomas are difficult to treat because they are situated in anatomically complex regions. One of the most common approaches for AFM meningiomas is the far lateral approach. We describe our exo- and endoscopic two-step approach (EETA) through suboccipital craniotomy. An exoscope is used to remove the tumour's lateral part, whereas an endoscope is used to remove the residual tumour in the exoscope's blind spots, including the brainstem's ventral side. EETA is a viable option for treating AFM meningiomas because it provides an adequate surgical field of view and is minimally invasive.