Pure endoscopic subfrontal keyhole approach for planum sphenoidale meningiomas and olfactory groove meningiomas

The standard treatment for planum sphenoidale meningiomas (PSMs) and olfactory groove meningiomas (OGMs) is resection. Traditional transcranial approaches and a variety of minimally invasive techniques, such as endoscopic endonasal and endoscope-assisted subfrontal approaches, have risen in popularity. The authors describe a surgical technique for PSMs and OGMs using a purely endoscopic subfrontal keyhole approach (PESKA). Gross-total resection was achieved in all patients using PESKA. There were no new neurological symptoms postoperatively. PESKA for PSMs and OGMs is a useful surgical technique that allows for a smaller craniotomy and faster surgery, resulting in less invasiveness for patients. The video can be found here: https://stream.cadmore.media/r10.3171/2025.10.FOCVID25145