Anatomical Step-by-Step Dissection of Complex Skull Base Approaches for Trainees: Surgical Anatomy of the Endoscopic Endonasal Approach to the Anterior Cranial Fossa

Abstract

Introduction: Microsurgical transcranial approaches have been classically described for the surgical treatment of anterior cranial fossa (ACF) lesions. The development of endoscopic techniques has made the endoscopic endonasal approaches (EEAs) to the ACF increasingly popular for lesions that involve both the nasal and intracranial regions of the ACF or purely intracranial pathologies of the ACF. One of the advantages of the EEAs to the ACF includes less brain retraction. Given the adoption of EEAs for several midline and paramedian lesions of the ACF, we aim to didactically describe the EEAs to the ACF in an anatomically based, step-by-step manner directed to skull base surgery trainees. Clinical cases and indications are also described.