<strong>Abstract</strong> <em>Introduction:</em> Lesions in the petrous apex region present a significant challenge for surgeons due to the deep location at the skull base and complex anatomical relations. The Kawase approach, or partial resection of the anterior petrous temporal bone, though widely adopted worldwide, remains under-researched in Vietnam. <em>Patients and Methods: </em>A cross-sectional descriptive study was conducted on 25 patients treated surgically using the Kawase approach at Viet Duc University Hospital from January 2022 to May 2024 <em>Results: </em>The average age was 53.9 years, with a male/female ratio of 1/5,25. Clinical symptoms included: Trigeminal nerve pain/numbness (60%), headaches (52%), and dizziness (40%). Regarding the histopathology aspect, there were Meningiomas (16), Trigeminal schwannomas (6), Chordomas (2), Teratoma (1). The average tumor size was 28 ±11.3mm. Ability of complete tumor resection were: total resection (14 cases), subtotal (4 cases), partial (6 cases), unresectable and biopsy only (1 case). The per-operative and postoperative complication rates accounted for 12%, however, no mortality was observed in this series. <em>Conclusions:</em> The Kawase approach is a safe and effective method for accessing tumors in the petrous apex region. <em>Keywords:</em> Petrous apex, Kawase approach, petrous bone – clivus. <strong>References</strong> <ol> <li>Mendez-Rosito, D., Anterior Petrosal Approach for the Resection of a Petrous Apex Meningioma with Tentorial Infiltration. J Neurol Surg B Skull Base, 2019. 80(Suppl 3): p. S304.</li> <li>Tomio, R., et al., Anterior transpetrosal approach: experiences in 274 cases over 33 years. Technical variations, operated patients, and approach-related complications. J Neurosurg, 2022. 136(2): p. 413-421.</li> <li>Wagner, A., et al., Surgical and Functional Outcome after Resection of 64 Petroclival Meningiomas. Cancers (Basel), 2022. 14(18).</li> <li>Li, M., et al., Trigeminal schwannoma: a single-center experience with 43 cases and review of literature. Br J Neurosurg, 2021. 35(1): p. 49-56.</li> <li>Ichimura, S., et al., Four subtypes of petroclival meningiomas: differences in symptoms and operative findings using the anterior transpetrosal approach. Acta Neurochir (Wien), 2008. 150(7): p. 637-45.</li> <li>Zhao, Z., et al., Treatment Strategy for Petroclival Meningiomas Based on a Proposed Classification in a Study of 168 Cases. Sci Rep, 2020. 10(1): p. 4655.</li> <li>Lin, Y., et al., Analysis of Approaches in the Microsurgical Treatment of 102 Cases of Petroclival Meningioma in a Single Center. Front Neurol, 2021. 12: p. 627736.</li> <li>Gao, B., et al., Surgical Treatment and Clinical Outcomes of Petroclival Meningiomas: A Single-Center Experience of 107 Patients. Front Oncol, 2021. 11: p. 761284.</li> <li>Giammattei, L., et al., Surgical morbidity of the extradural anterior petrosal approach: the Lariboisiere experience. J Neurosurg, 2023. 138(1): p. 276-286.</li> <li>Park, C.K., et al., The selection of the optimal therapeutic strategy for petroclival meningiomas. Surg Neurol, 2006. 66(2): p. 160-5; discussion 165-6.</li> <li>Kawase, T., Advantages and disadvantages of surgical approaches to petroclival lesions. World Neurosurg, 2011. 75(3-4): p. 421.</li> </ol>
