Peripheral Nerve |
Functional |
Paediatric Neurosurgery |
Skull Base surgery refers to the different technical approaches employed to tackle different pathologies at the base of the skull. Such tumours are often difficult to reach and extensive. These approaches enable the neurosurgeon to reach such lesions with:
| 1. | Increased exposure. This allows microsurgery to be performed in deep-seated areas. | |
| 2. | Early vascular control. Skull base approaches often directly involve areas where crucial blood vessels enter. This allows early demonstration and protection of these vessels. |
In the 60's, such approaches were not well developed. Today, the different skull base approaches allows the neurosurgeons to tackle problems in 'difficult' and 'deep' areas. Endoscopy and neuronavigation are often used to augment the neurosurgeon's ability to perform such surgery more safely. While some skull base approaches are performed by the neurosurgeon alone, collaboration with the head & neck surgeon, maxillary-facial surgeon, otolaryngolosits, neurotologist or plastic surgeon is sometimes necessary.
| ` | 1. | Acoustic Neuromas |
| 2. | Cerebellopontine angle tumours (eg, meningioma) | |
| 3. | Petroclival tumours | |
| 4. | Foramen magnum tumours | |
| 5. | Jugular foramen lesions (eg, schwnnomas, paragangliomas) | |
| 6. | Cevernous sinus lesions | |
| 7. | Sphenoid wing meningiomas | |
| 8. | Frotal base lesions (eg planum sphenoidale megningioma, tuberculum sellae meningioma, hypothalamic tumours0 | |
| 9. | Pituitary adenomas | |
| 10. | Nasopharyngeal cancer |
The different skull base approaches include:
| 1. | Frontal Basal | |
| 2. | Orbitozygomatic | |
| 3. | Craniofacial | |
| 4. | Mid-facial transmaxillary | |
| 5. | Transoral | |
| 6. | Preauricular infratentorial | |
| 7. | Translabyrinthine | |
| 8. | Retrosignmoid | |
| 9. | Presigmoid petrosal | |
| 10 | Far lateral transcondylar | |
| 11. | Extreme lateral, transjugular |