Lateral supraorbital approach for large olfactory groove meningioma and unruptured large anterior communicating artery aneurysm: operative video and technical considerations

Anterior skull base meningiomas can be approached via frontotemporal, interhemispheric, lateral supraorbital (LSO), transeyebrow supraorbital, or endonasal transsphenoidal approaches. The LSO approach, with extensive orbital roof drilling, provides a sufficient corridor to reach tumors located most anteriorly while achieving a favorable cosmetic outcome. This video demonstrates the utility of the LSO approach for resection of a large olfactory groove meningioma infiltrating the pia mater and clipping of a large anterior communicating artery (Acom) aneurysm. Even for a superiorly projecting Acom aneurysm, the space created after tumor resection allowed wide interhemispheric dissection and adequate exposure of the aneurysm. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25165.