Chapter 13 - Transoral Approaches to Midline Skull Base Tumors

Abstract

Transoral approaches have a significant advantage in providing the most direct route to ventral skull base pathology. Extended transoral approaches such as palatotomy, mandibular split, and mandibuloglossotomy can be used for increased rostrocaudal surgical access. Although these approaches give the easiest access to the lower craniocervical junction, the risks of postoperative infection and cerebrospinal fluid leak have to be considered. Preoperative management of dental disease, meticulous intraoperative reconstruction, and postoperative antibiotics assist in managing these complications. Combining endoscopic transoral and endonasal approaches provides improved surgical access and decreases the morbidity associated with the extended transoral approaches.