title: Anatomy and surgery of the endoscopic endonasal approach to the skull base.
abstract: The midline skull base is an anatomical area, which extends from the anterior limit of the anterior cranial fossa down to the anterior border of the foramen magnum. For many lesions of this area, a variety of skull base approaches including anterior, antero-lateral, and postero-lateral routes, have been proposed over the last decades, either alone or in combination, often requiring extensive neurovascular manipulation. Recently the endoscopic endonasal approach to the skull base has been introduced to access the midline skull base. The major potential advantage of the endoscopic endonasal technique is to provide a direct anatomical route to the lesion since it does not traverse any major neurovascular structures, thereby obviating brain retraction. The potential disadvantages include the relatively restricted exposure and the higher risk of CSF leak. In the present study we report the endoscopic endonasal anatomy of different areas of the midline skull base from the olfactory groove to the cranio-vertebral junction and accordingly describe the main features of the surgical approaches to each of these regions.
authors.affiliation: Department of Neurological Sciences, Division of Neurosurgery, Università degli Studi di Napoli Federico II, Naples, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Solari
authors.forename: Alessandro
authors.initials: A
authors.lastname: Villa
authors.forename: Michelangelo
authors.initials: M
authors.lastname: De Angelis
authors.forename: Felice
authors.initials: F
authors.lastname: Esposito
authors.forename: Luigi Maria
authors.initials: LM
authors.lastname: Cavallo
authors.forename: Paolo
authors.initials: P
authors.lastname: Cappabianca
keywords: endoscopic anatomy; endoscopic endonasal surgery; endoscopy; skull base surgery
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