What is traditional skull base surgery?
There are many ways to approach the skull base. In the past, the favored technique was to approach the skull base from above (transcranial approach) and from below (transfacial approach), commonly at the same time. The transcranial approach consists of a scalp incision followed by a craniotomy (removing part of the skull). The brain is then lifted up to reach the skull base. The bones of the facial skeleton may be removed temporarily to increase the exposure. The transfacial approach consists of incisions on the face or inside the mouth that provide access to the sinus cavities and skull base from below. Working both above and below the skull base, the surgeons then remove tumors that are at the skull base. Surgery results in a defect of the skull base and dura (thick lining over the brain) that needs to be repaired to prevent leakage of spinal fluid and infection (meningitis).
