EVOLUTION AND ADVANCES OF THE LATERAL SURGICAL APPROACHES TO CRANIAL BASE NEOPLASMS

The evolution and advances of the lateral surgical approaches used for neoplasms of the cranial base involving the middle and posterior cran ial fossa are reviewed. The lateral approaches available for access to the cranial base are diverse and are often used in combination. Appro aches for tumors that are completely extradural, usually involving the temporal bone or infratemporal fossa, include the infratemporal fossa approach described by Fisch and the preauricular subtemporal-infratem poral fossa approach. Lateral approaches used to provide exposure of i ntradural tumors involving the clivus and traversing the middle and po sterior cranial fossa are based on the following approaches: the front otemporal orbitozygomatic, subtemporal/middle fossa, transpetrosal, la teral suboccipital, and transcondylar approaches. The great strides th at have been made in the safe and effective surgical treatment of cran ial base neoplasms are due, in part, to the availability of multiple s urgical approaches and the ability to tailor the planned operative pro cedure to the precise location and extent of the cranial base tumor.