A millennium review of skull base surgery

Skull base surgery is a recent development in our history, in as much as mo st of the surgical techniques involved have been described within the last century. To provide an historical prospective the author reviews the develo pment of this specialty, arbitrarily dating its beginning some five centuri es ago with the work of Leonardo da Vinci. By picking this period we includ e the origin of scientific anatomy and personages interested in developing new ideas and concepts who were able to leave the stagnant period of the Mi ddle Ages behind. In 1900 surgeons worked alone, with the concept of a skul l base "team" not yet existing. Endotracheal intubation and controlled resp iration was just being introduced. Intraoperative monitoring of blood press ure, pulse rate and respiration was not yet known. Harvey Gushing was to in troduce this concept in the first decade of the last century. This survey t races the ori gins of modern skull base surgery from its antecedents in the Renaissance to the beginning of this century. A paper of this length can o nly provide a sampling of themes and personalities; nevertheless, it will g ive the reader an impressive overview of how far we have come and some idea s of what the future holds.