Surgical management of anterolateral skull base lesions

The following section outlines major considerations in the treatment of anterolateral skull base lesions. The essential anatomy, including the nasosinal region as well as the anterior fossa, is presented and the related challenge of defining the appropriate surgical approach is highlighted. We report on our principles of preoperative investigations and demonstrate the cornerstones of the perisurgical treatment for patients with lesions of the anterolateral skull base in our department. The chapter focuses on surgical decision-making and surgical techniques, it covers the most relevant approaches in managing anterolateral lesions. Detailed descriptions of the anterior interhemispheric approach, the supraorbital craniotomy, and minicraniotomy, the extended endoscopic endonasal approach, the orbitozygomatic approach, and the Fisch approaches are provided. Finally, we present and discuss the surgically relevant nuances of four selected cases to highlight and discuss the controversies for and against the choice of a particular approach.