Intro -- Foreword: Skull Base Surgery -- Preface -- Acknowledgments -- Contents -- 1: General Considerations -- 1.1 Concepts Underlying Anterior Skull Base Surgery -- 1.2 Evolution ofAnterior Skull Base Surgery -- 1.3 Skull Base Approaches -- Need forGood Anatomical Knowledge withTransnasal Approaches -- 1.4 General Workup forSkull Base Procedures -- Imaging -- Image Guidance -- Patient Positioning -- Anaesthesia -- Temporary Tarsorrhaphy -- Lacrimal Stenting -- References -- 2: Sub-frontal Approach (Spectacle Incision Approach) -- 2.1 Workup ofCases -- 2.2 Patient Position -- 2.3 Anaesthesia -- 2.4 Image Guidance -- 2.5 Microscope -- 2.6 Frozen Section Facilities -- 2.7 Surgical Approach -- Trans-Nasal Approach totheSkull Base -- Bi-Coronal Approach -- Spectacle Incision andGlabella Bone Flap (Sub-frontal) -- Design ofBone Flap -- Soft Tissue Approach -- Clearance ofNasal Extent oftheDisease -- Resection oftheSkull Base andIntracranial Portion oftheTumour -- Dural Repair -- Resection ofInvolved Orbital Periosteum -- Lacrimal Stenting -- Packing oftheCraniofacial Cavity -- Bone Repair -- Bone Flap Repair -- Skin Closure -- Alternative Methods ofDural Repair -- References -- 3: Supraorbital Craniotomy -- 3.1 Skin Incision -- 3.2 Placement oftheInitial Entry Point -- 3.3 Bone Flap Completed -- 3.4 The Dura -- 3.5 Dural Opening -- 3.6 Intracranial Exposure -- 3.7 Closure -- Suggested Reading -- 4: Orbitozygomatic Approach -- 4.1 Head Position (Fig.4.1) -- 4.2 Skin Incision -- 4.3 Completed Scalp Flap -- 4.4 Pterional Bone Flap (Fig.4.3) -- 4.5 Orbitozygomatic Osteotomy (Fig.4.4) -- 4.6 Dural Exposure (Figs.4.5 and4.6) -- 4.7 Dural Reflection (Fig.4.6) -- 4.8 Dural Closure 9 Replacement of Orbitozygomatic Bony Flap (Fig.4.7) -- 4.9 Replacement ofPterional Bone Flap

4.10 Repair ofTemporalis Muscle -- 4.11 Skin Closure (Fig.4.8) -- Suggested Reading -- 5: Le Fort 1 Approach -- 5.1 Approach Diagram (Fig.5.1) -- 5.2 Patient Position -- 5.3 Sublabial Incision Marking (Fig.5.2) -- 5.4 Sublabial Incision toBone (Fig.5.3) -- 5.5 Placement ofMetal Plates (Fig.5.4) -- 5.6 Anterior Maxillary Osteotomy (Fig.5.5) -- 5.7 Posterior Osteotomy (Fig.5.6) -- 5.8 Mobilisation andRetraction (Fig.5.7) -- Lateral View ofMobilisation (Fig.5.8) -- 5.9 Archer Retractor (Fig.5.9) -- Archer Retractor InSitu (Fig.5.10) -- 5.10 Placement ofMetal Plates (Fig.5.11) -- 5.11 Mucosal Closure (Fig.5.12) -- 6: Midfacial Degloving -- 6.1 Introduction -- 6.2 Patient Position -- 6.3 Anaesthesia -- 6.4 Rhinoplasty Approach -- 6.5 Elevation oftheFacial Skin over theAnterior Aspect oftheMaxilla -- Position andInjection forSublabial Incision (Figs.6.7, 6.8, and6.9) -- 6.6 Linking theLabial andNasal Incisions andFlap Elevation -- 6.7 Medial Maxillectomy toExpose theAntrum andSkull Base -- Elevation ofNasal Mucosa fromLateral Wall (Figs.6.13 and6.14) -- 6.8 Bony Steps oftheMedial Maxillectomy -- Removal oftheAnterior Wall oftheMaxilla -- Identification andOpening oftheLacrimal Canal -- Removal oftheLateral Bony Wall -- 6.9 Management Juvenile Angiofibroma -- 6.10 Reconstruction oftheSkull Base: Nasal Septal Flap -- Extension oftheBone Removal oftheMedial Maxillectomy toExpose theCentral Skull Base -- Anatomy ofthePterygopalatine Fossae -- Exploration oftheLateral Skull Base via Pterygopalatine Fossa -- Exploration ofthePituitary Fossa andIts Surrounding Structures -- 6.11 Reconstruction ofSkull Base andClosure -- Lacrimal Stenting -- Nasal Packing -- Suturing -- 6.12 Immediate Post-operative Care -- References -- Suggested Reading -- 7: Lateral Rhinotomy

7.1 Foramina ofSphenoid Bone -- 7.2 Soft-Tissue Approaches -- 7.3 Bony Approaches (Fig.7.2) -- 7.4 Maxillectomy -- 7.5 Medial Maxillectomy Procedure (Fig.7.3) -- 7.6 Patient Workup -- 7.7 Patient Position andAnaesthesia -- 7.8 Technique forMedial Maxillectomy Approach -- Indications forUse -- Incision Design -- Exposure ofAnterior andSuperior Walls oftheMaxilla -- Separation ofNasal Soft Tissues fromMedial Aspect ofMaxilla -- 7.9 Mobilisation ofOrbital Floor -- 7.10 Medial Maxillectomy Osteotomies -- 7.11 Alternative Method ofReconstruction -- The Septal Mucosal Flap -- Maxillectomy andOrbital Exenteration -- Operative Technique -- Soft-Tissue Approach -- Facial Incision (Fig.7.16a) -- Oral Incisions (Fig.7.16b) -- Nasal Incision -- 7.12 Maxillectomy Osteotomies (Fig.7.18) -- 7.13 Possible Resection oftheInferior Orbital Periosteum -- 7.14 Repair -- 7.15 Immediate Post-operative Rehabilitation -- 7.16 Maxillofacial Technical Help -- 7.17 Orbital Exenteration -- Additional Steps Needed forOrbital Exenteration -- Additional Removal oftheOrbital Wall Following Maxillectomy -- References -- Suggested Reading -- 8: Bicoronal Flap, Frontal Craniotomy -- 8.1 Patient Position (Fig.8.2) -- 8.2 Shaving (Fig.8.3) -- 8.3 Incision (Fig.8.4a, b) -- 8.4 Application ofHaemostatic Clips (Fig.8.5) -- 8.5 Raising theScalp Flap (Fig.8.6) -- 8.6 Raising thePericranial Flap (Figs.8.7 and8.8) -- 8.7 Anatomical Landmarks (Fig.8.9) -- 8.8 Exposure oftheSuperior Orbital Margin (Fig.8.10) -- 8.9 Glabellar Flap (Fig.8.11) -- 8.10 Application ofTitanium Mini-Plates (Fig.8.12) -- 8.11 Drill Placement (Fig.8.13) -- 8.12 Exposure andRemoval ofPosterior Wall ofFrontal Sinus (Fig.8.14) -- 8.13 Dural Incision andTumour Exposure (See Figs. 2.11 and2.12) -- 8.14 Tumour Removal (See Fig. 2.13)

8.15 Dural Repair (See Figs. 2.15 and2.16) -- 8.16 Replacement ofBone Flap (See Fig. 2.20) -- 8.17 Unilateral Frontal Flap (Fig.8.15) -- 8.18 Bifrontal Flap (Fig.8.16) -- 8.19 Craniotome (Fig.8.17) -- 8.20 Elevation ofBone Flap (Fig.8.18) -- 8.21 Retraction ofFrontal Lobes andExposure ofOrbital Roofs andCribriform Plate (Fig.8.19) -- 8.22 Skin Closure (Fig.8.20) -- 8.23 Cranioplasty: Planned Replacement ofInvolved Skull withaPreformed Cranioplasty (Figs.8.21, 8.22, 8.23, 8.24, and8.25) -- Suggested Reading

This illustrated book represents a genuinely multi-disciplinary and collaborative approach to the standard procedures in skull base surgery. It emphasizes the basic operative steps of each approach and describes variations from the basic approach