Transbasal Approach

Abstract

At first sight, it seems a long way from the anterior skull base to the clivus; however, the approach described below offers a wide range of variations and is fruitful ground for intraoperative cooperation with ENT surgeons. Nevertheless, this chapter is not meant to provide a detailed description of anterior skull base surgery, but rather to point out that it is possible to reach the clivus by an anterior skull base approach. The development of this approach was naturally founded on decades of experience in anterior skull base surgery (Unterberger 1958; Pertuiset 1955; Guiot and Derome 1966; Bonnal et al. 1961; Van Buren et al. 1968); it also comprises surgery of the orbit (Naffziger 1941; Brihaye et al. 1968; Schürmann and Voth 1972) and has been further enhanced by the progress made by Tessier in the field of craniofacial surgery (Tessier 1973; Tessier et al. 1967, 1973). In 1972, Derome and associates presented a comprehensive description of sphenoethmoidal surgery and laid the foundation of the “transbasal” approach to the clivus (Derome 1972; Derome and Guiot 1979; Arita et al. 1989).