The paper reviews the role of the maxillofacial surgeon, surgical appr
oaches and osteotomies available to allow comprehensive access to cran
ial base tumours. Maxillo facial reconstruction using free vascularise
d flaps to rehabilitate the patients is highlighted. Such reconstructi
on may also require vascularised bone grafts. The range of microvascul
ar free tissue transfer in cranial base surgery is discussed. The need
not to merely reconstruct but to rehabilitate the patient is stressed
. The benefits of the latest imaging and navigation systems are outlin
ed.