Lateral Approaches to the skull base - S I O e Ch CF 2025

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From review of our experience and the available literature, the selection of approaches to the lateral skull base involve translabyrinthine, transcochlear, translab-transapical, retrosigmoid, sub-temporal, lateral/subtotal/total petrosectomy, infratemporal and petro-occipital-transigmoid approaches.
Approaches described for use in pediatric lateral skull base surgery include subtotal petrosectomy, translabyrinthine approach (TLA), retrosigmoid approach, combined translabyrinthine/retrosigmoid approach, transotic approach, infralabyrinthine approach, infratemporal fossa approaches, and MCF approach.
The temporal bone is located centrally in lateral skull base and forms part of the middle and posterior cranial fossae. It articulates with the occipital, parietal, sphenoid, and zygomatic bones and is divided into five parts: squamous, petrous, mastoid, and tympanic portions and the styloid process.
The surgical approach most commonly used is a bifrontal craniotomy through a bicoronal incision with pericranial flap preservation for skull base reconstruction. The bifrontal craniotomy is accompanied with exenteration of the frontal and ethmoidal sinuses if necessary.
Lateral skull base surgery can be completed either endoscopically or using a microsurgical approach, and can be used to treat conditions like meningiomas, acoustic neuromas, glioma tumors, encephaloceles, cholesteatomas, schwannomas, and glomus tumors.
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Skull base surgery can be done in two main ways. Although the preferred method is endoscopic, open surgery is also an option, depending on the type of growth that needs to be removed and its location: Endoscopic or minimally-invasive skull base surgery. This type of surgery usually does not require a large incision.
Open Surgical Approaches for the Anterior Skull Base The extent of exposure of these approaches include the frontal sinus anteriorly, the clivus posteriorly, the frontal lobe superiorly, and the paranasal sinuses, the pterygo-maxillary fossa and infratemporal fossa inferiorly.

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