Craniofacial approaches to the anterior skull base

Malignancies of the anterior skull base commonly present with benign symptomatology, causing a delay in diagnosis and involvement of structures that present a technical challenge in resection. Modern surgical techniques have made approaches to this region, previously thought inaccessible, both technically feasible and therapeutically effective. This has resulted in surgical management often being considered the primary treatment modality for the various pathologic disease processes affecting the anterior skull base. Although open craniofacial methods have remained the traditional approach for surgical treatment, technologic advances have made transfacial endoscopic techniques both accessible and appealing. This article describes the authors' method for craniofacial approaches to the anterior skull base.