الفهرس 
Skull base anatomyOnly 14 pages are availabe for public view
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Abstract
The skull base is a highly complex region with multiple bony foramina through which pass several important neurovascular structures. Because all the neurovascular connections between the brain and the neck pass through the foramina within the cranial base, skull base tumors are surrounded by multiple vital structures; therefore , safe removal poses a considerable surgical challenge .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 endoscopic technique requires different instrumentation, consisting in different components: the endoscope, the fiberoptic cable, the light source, the camera, the monitor, and the video recording system, related one to another as a “clock mechanism”. Besides, further advantages have been identified: the endoscopic endonasal technique turned out to be a lesser traumatic procedure for the nasal structures, with a minimal postoperative pain and a better relief after surgery, in the majority of cases, does not requiring any nasal packing.Because surgical excision is the treatment of choice for the vast majority of skull base lesions, Resection of lesions involving this area requires a variety of skull base approaches. These include anterior, anterolateral and posterolateral routes ,performed either alone or in combination, and resection via these routes often requires extensive neurovascular manipulation .Over the past 20 years, advances in anesthesia, improvements in surgical technology, and refinements in reconstructive modalities have enabled surgical removal of cranial base tumors that were previously associated with unacceptable morbidity. The constant improvements in diagnostic imaging techniques and the increasing use of image guidance systems during endoscopic endonasal procedures has provided increasing accuracy, safety and allowed an improved, constant surgical orientation in an anatomically complex area.