Combined endoscopic and open approach to resection of the anterior skull base

Although en-bloc resection is the traditional teaching in oncological surgery, with recent technologic advancements and literature to support both safety and efficacy, there has been a growing acceptance of alternative techniques for the surgical management of paranasal sinus and anterior skull base malignancies. The endoscopic-assisted external approach affords many of the benefits of endoscopic resection while allowing for the management of lesions with marked intracranial extension that would otherwise require anterior craniofacial resection. Here we describe our endoscopic technique for resection of the anterior skull base and its role when combined with anterior craniotomy.