[Transnasal endoscopic approaches to the cranial base]

Abstract

Recent advances in surgical endoscopy have made it possible to reach nearly the whole cranial base through a transnasal approach. These 'expanded approaches' lead to the frontal sinuses, the cribriform plate and planum sphenoidale, the suprasellar space, the clivus, odontoid and atlas. By pointing the endoscope laterally, the surgeon can explore structures in the coronal plane such as the cavernous sinuses, the pyramid and Meckel cave, the sphenopalatine and subtemporal fossae, and even the middle fossa and the orbit. The authors of this contribution use most of these approaches in their endoscopic skull base surgery. The purpose of this contribution is to review the hitherto established endoscopic approaches to the skull base and to illustrate them with photographs obtained during self-performed procedures and/or cadaver studies.