1 Preoperative Evaluation and Management from the Neurosurgical Perspective Raymond Walkup and Jeffrey J. Olson   INTRODUCTION Taking a history and doing a general physical and neurologic evaluation should be part of every skull base surgeon's training. This said, it is still reasonable to review the salient points of this activity, which can serve as a point of a departure toward obtaining information directed at a given individual's specific malady. By obtaining this information, one can best -- 2 Anterior Skull Base Preoperative Evaluation from the Otolaryngologic Perspective J. Nicolas McLean and Charles E. Moore   INTRODUCTION Anatomically, the skull base can be divided into the anterior, middle, and posterior fossae. The lesser and greater wings of the sphenoid bone divide the anterior fossa from the middle fossa, and the petrous pyramid and mastoid portions of the temporal bone divide the middle and posterior fossae. The parietal and occipital lobes of the brain do not directly con -- 3 Craniofacial Approach to Skull Base Lesions Jeremy N. Ciporen, Jeffrey J. Olson, and Charles E. Moore   INTRODUCTION The craniofacial approach depicted in this chapter is utilized mainly to resect neoplasms that invade the dura and/or extend intracranially from the sinuses or orbits. Less frequently, the converse situation exists in terms of site of origin and direction of invasion -- however, the principles of the approach remain the same. The following stepwise description will enable the surg.

4 Petrosal Craniotomy Tomoko Tanaka, Douglas E. Mattox, and Jeffrey J. Olson   GENERAL INDICATIONS FOR PETROSAL CRANIOTOMY Petrosal craniotomy is designed for reaching lesions in and around the petrous bone by shortest distance while preserving as many normal structures as possible. It is broadly applicable and modifiable for disease involving the lateral and posterior skull base. Structures relevant to this surgical approach include the bony, neurologic, and vascular contents of the middle cran -- 5 Endoscopic Endonasal Skull Base Surgery Vladimir Dadashev, David V. LaBorde, and Costas G. Hadjipanayis   INTRODUCTION One of the major challenges in transphenoidal surgery has been the adequate visualization of anatomical structures. During the past decade, endoscopic endonasal transphenoidal surgery has been progressively accepted by surgeons and patients as a minimally invasive approach permitting panoramic vision close to the surgical target with minimal trauma. The endoscope is used as a -- 6 Endoscopic Tumor Resection and Cerebrospinal Fluid Leak Repair Jodi D. Zuckerman and John M. DelGaudio   INTRODUCTION With the advent of endoscopic techniques in the early 1980s, the surgical approach to the skull base has gone through a dramatic transformation. Sinonasal tumors that once could only be accessed through external approaches now are accessible through an endoscopic sinonasal approach. This chapter outlines the preoperative planning and endoscopic surgical techniques for tumor rem.

7 Orbitozygomatic Approach to the Sellar Region David V. LaBorde and Nelson M. Oyesiku   INTRODUCTION The orbitozygomatic (OZ) craniotomy is an approach that every skull base neurosurgeon should have in his or her armamentarium. The approach provides wide access to the medial sphenoid wing, the anterior cranial fossa, the middle cranial fossa, the upper one third of the posterior fossa, the upper one third of the clivus, the sellar and parasellar region as well as Meckel's cave. The approach all -- 8 Far Lateral Suboccipital Approach Vaninder S. Chhabra, Daniel L. Barrow, and Gerald R. Rodts   INTRODUCTION The far lateral or transcondylar suboccipital approach allows for visualization of the anterior aspect of the spinal canal and foramen magnum while avoiding retraction of the spinal cord or brainstem. The approach can be summarized in a three-step process. The exposure first requires careful dissection of the muscles along the posterolateral aspect of the craniocervical junction to provi -- 9 Postoperative Evaluation and Management of the Skull Base Patient Frederick L. Durden and Charles E. Moore   INTRODUCTION As demonstrated in previous chapters, skull base lesions involve a diverse collection of pathologic diagnosis and locations. Surgical procedures require manipulation of major neurologic and vascular structures. Like the preoperative and intraoperative approach to the care for patients with skull base lesions, management of these patients postoperatively requires many consul.

10 Ancillary Procedures in Skull Base Surgery G. Aaron Rogers and Charles E. Moore   ANCILLARY SUPPORT AND PROCEDURES IN SKULL BASE SURGERY The operative complexities of skull base surgery necessitate a team-based approach and organization to total patient care. No single specialty can expect to assume the role of primary caretaker of such a complex patient without substantial input from ancillary services and other medical subspecialties. Although the most acute phase of the patient's care and -- 11 Imaging of the Anterior and Central Skull Base Amanda Corey   INTRODUCTION Computed tomography (CT) and magnetic resonance imaging (MRI) are the workhorses for imaging of the anterior and central skull base. Lesions can affect the skull base from above, from below, or arise directly from the skull base itself. If a lesion of the head and neck is suspected or has been detected clinically, these imaging modalities can offer the ordering physician information about the lesion origin and local ex.