Skip to main content
SpringerLink
Log in

Skull Base

  • Chapter
  • First Online:
Atlas of Head Neck and Skull-base Surgery

  • 218 Accesses

Abstract

Progress in microsurgery, endoscopy, imaging and reconstruction has improved surgical options for cranial base lesions. Adjuvant non-surgical therapies have improved outcomes for certain illnesses, leading to excision being seen as the primary therapeutic modality for many once thought to be incurable. The cranial base is formed by the anterior, middle and posterior skull base; all these structures contribute to the craniofacial junction. They are connected to the orbits, nasal airways and paranasal sinuses and are thus affected by similar pathogenic processes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 119.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kirkman M, Borg A, Al-Mousa A, Haliasos N, Choi D. Quality-of-life after anterior skull base surgery: a systematic review. J Neurol Surg Part B Skull Base. 2013;75(02):073–89.

    Article  Google Scholar 

  2. Fletcher AM, Marentette L. Anterior skull-base surgery: current opinion. Curr Opin Otolaryngol Head Neck Surg. 2014;22(4):322–5.

    Article  PubMed  Google Scholar 

  3. Peris-Celda M, Kucukyuruk B, Monroy-Sosa A, Funaki T, Valentine R, Rhoton AL. The recesses of the sellar wall of the sphenoid sinus and their intracranial relationships. Oper Neurosurg 2013;73:ons117–31.

    Google Scholar 

  4. Fernandez-Miranda JC, Prevedello DM, Madhok R, Morera V, Barges-Coll J, Reineman K, et al. Sphenoid septations and their relationship with internal carotid arteries: anatomical and radiological study: sphenoid septa. Laryngoscope. 2009;119(10):1893–6.

    Article  PubMed  Google Scholar 

  5. Daniel PM. Anatomy of the hypothalamus and pituitary gland. J Clin Pathol. 1976;7(1):1–7.

    Article  CAS  Google Scholar 

  6. Lechan RM, Toni R. Functional anatomy of the hypothalamus and pituitary. In: Feingold KR, Anawalt B, Boyce A, Chrousos G, de Herder WW, Dhatariya K, et al., editors. Endotext. South Dartmouth (MA): MDText.com, Inc.; 2000. [cited 2022 Dec 18]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK279126/.

    Google Scholar 

  7. Krisht AF, Barrow DL, Barnett DW, Bonner GD, Shengalaia G. The microsurgical anatomy of the superior hypophyseal artery. Neurosurgery. 1994;35(5):899–903. discussion 903

    Article  CAS  PubMed  Google Scholar 

  8. Cecchini G. Anterior and posterior ethmoidal artery ligation in anterior skull base meningiomas: a review on microsurgical approaches. World Neurosurg. 2015;84(4):1161–5.

    Article  PubMed  Google Scholar 

  9. Hofmann E, Prescher A. The clivus: anatomy, normal variants and imaging pathology. Clin Neuroradiol. 2012;22(2):123–39.

    Article  CAS  PubMed  Google Scholar 

  10. Wang WH, Abhinav K, Wang E, Snyderman C, Gardner PA, Fernandez-Miranda JC. Endoscopic endonasal transclival transcondylar approach for foramen magnum meningiomas: surgical anatomy and technical note. Oper Neurosurg (Hagerstown). 2016;12(2):153–62.

    Article  PubMed  Google Scholar 

  11. Fernandez-Miranda JC, Morera VA, Snyderman CH, Gardner P. Endoscopic endonasal transclival approach to the jugular tubercle. Neurosurgery. 2012;71(Suppl. 1):146–58. discussion 158–159

    PubMed  Google Scholar 

  12. Morera VA, Fernandez-Miranda JC, Prevedello DM, Madhok R, Barges-Coll J, Gardner P, et al. “Far-medial” expanded endonasal approach to the inferior third of the clivus: the transcondylar and transjugular tubercle approaches. Neurosurgery. 2010;66(Suppl. 6):211–9. discussion 219–220

    PubMed  Google Scholar 

  13. Rhoton AL. The cerebellar arteries. Neurosurgery. 2000;47(Suppl. 3):S29–68.

    PubMed  Google Scholar 

  14. Scopel TF, Fernandez-Miranda JC, Pinheiro-Neto CD, Peris-Celda M, Paluzzi A, Gardner PA, et al. Petrous apex cholesterol granulomas: endonasal versus infracochlear approach. Laryngoscope. 2012;122(4):751–61.

    Article  PubMed  Google Scholar 

  15. Paluzzi A, Gardner P, Fernandez-Miranda JC, Pinheiro-Neto CD, Scopel TF, Koutourousiou M, et al. Endoscopic endonasal approach to cholesterol granulomas of the petrous apex: a series of 17 patients: clinical article. J Neurosurg. 2012;116(4):792–8.

    Article  PubMed  Google Scholar 

  16. Pinheiro-Neto CD, Fernandez-Miranda JC, Rivera-Serrano CM, Paluzzi A, Snyderman CH, Gardner PA, et al. Endoscopic anatomy of the palatovaginal canal (palatosphenoidal canal): a landmark for dissection of the vidian nerve during endonasal transpterygoid approaches. Laryngoscope. 2012;122(1):6–12.

    Article  PubMed  Google Scholar 

  17. Fernandez-Miranda JC. Intracranial region. In: Standring S, editor. Gray’s anatomy. Philadelphia, PA: Elsevier Health Sciences; 2015. p. 429–42.

    Google Scholar 

  18. Patel CR, Fernandez-Miranda JC, Wang WH, Wang EW. Skull base anatomy. Otolaryngol Clin N Am. 2016;49(1):9–20.

    Article  Google Scholar 

  19. Tomovic S, Esmaeili A, Chan NJ, Choudhry OJ, Shukla PA, Liu JK, et al. High-resolution computed tomography analysis of the prevalence of onodi cells. Laryngoscope. 2012;122(7):1470–3.

    Article  PubMed  Google Scholar 

  20. Campero A, Martins C, Yasuda A, Rhoton AL. Microsurgical anatomy of the diaphragma sellae and its role in directing the pattern of growth of pituitary adenomas. Neurosurgery. 2008;62(3):717–23.

    Article  PubMed  Google Scholar 

  21. Grewal SS, Kurbanov A, Anaizi A, Keller JT, Theodosopoulos PV, Zimmer LA. Endoscopic endonasal approach to the maxillary strut: anatomical review and case series: maxillary strut: an endoscopic landmark. Laryngoscope. 2014;124(8):1739–43.

    Article  PubMed  Google Scholar 

  22. Shao YX, Xie X, Liang HS, Zhou J, Jing M, Liu EZ. Microsurgical anatomy of the greater superficial petrosal nerve. World Neurosurg. 2012;77(1):172–82.

    Article  PubMed  Google Scholar 

  23. Lund VJ. Extended applications of endoscopic sinus surgery—the territorial imperative. J Laryngol Otol. 1997;111(4):313–5.

    Article  CAS  PubMed  Google Scholar 

  24. Sethi DS, Pillay PK. Endoscopic management of lesions of the sella turcica. J Laryngol Otol. 1995;109(10):956–62.

    Article  CAS  PubMed  Google Scholar 

  25. Sethi DS, Stanley RE, Pillay PK. Endoscopic anatomy of the sphenoid sinus and sella turcica. J Laryngol Otol. 1995;109(10):951–5.

    Article  CAS  PubMed  Google Scholar 

  26. Stankiewicz JA. The endoscopic approach to the sphenoid sinus. Laryngoscope. 1989;99(2):218–21.

    Article  CAS  PubMed  Google Scholar 

  27. Heilman CB, Shucart WA, Rebeiz EE. Endoscopic sphenoidotomy approach to the sella. Neurosurgery. 1997;41(3):602–7.

    CAS  PubMed  Google Scholar 

  28. Cappabianca P, Alfieri A, de Divitiis E. Endoscopic endonasal transsphenoidal approach to the sella: towards functional endoscopic pituitary surgery (FEPS). Minim Invasive Neurosurg. 1998;41(2):66–73.

    Article  CAS  PubMed  Google Scholar 

  29. Griffith HB, Veerapen R. A direct transnasal approach to the sphenoid sinus. Technical note. J Neurosurg. 1987;66(1):140–2.

    Article  CAS  PubMed  Google Scholar 

  30. Dew LA, Haller JR, Major S. Transnasal transsphenoidal hypophysectomy: choice of approach for the otolaryngologist. Otolaryngol—Head Neck Surg Off J Am Acad Otolaryngol-Head Neck Surg. 1999;120(6):824–7.

    Article  CAS  Google Scholar 

  31. Kenan PD. The rhinologist and the management of pituitary disease. Laryngoscope. 1979;89(2 Pt 2 Suppl. 14):1–26.

    CAS  PubMed  Google Scholar 

  32. Khan DZ, Ali AMS, Koh CH, Dorward NL, Grieve J, Layard Horsfall H, et al. Skull base repair following endonasal pituitary and skull base tumour resection: a systematic review. Pituitary. 2021;24(5):698–713.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Cai X, Yang J, Zhu J, Tang C, Cong Z, Liu Y, et al. Reconstruction strategies for intraoperative CSF leak in endoscopic endonasal skull base surgery: systematic review and meta-analysis. Br J Neurosurg. 2022;36(4):436–46.

    Article  PubMed  Google Scholar 

  34. Mattavelli D, Fiorentino A, Tengattini F, Colpani A, Agnelli S, Buffoli B, et al. Additive manufacturing for personalized skull base reconstruction in endoscopic transclival surgery: a proof-of-concept study. World Neurosurg. 2021;155:e439–52.

    Article  PubMed  Google Scholar 

  35. Singh H, Essayed WI, Schwartz TH. Endoscopic technology and repair techniques. Handb Clin Neurol. 2020;170:217–25.

    Article  PubMed  Google Scholar 

  36. Youngerman BE, Kosty JA, Gerges MM, Tabaee A, Kacker A, Anand VK, et al. Acellular dermal matrix as an alternative to autologous fascia lata for skull base repair following extended endoscopic endonasal approaches. Acta Neurochir. 2020;162(4):863–73.

    Article  PubMed  Google Scholar 

  37. Carnevale C, Tomás-Barberán M, Til-Pérez G, Ibañez-Domínguez J, Arancibia-Tagle D, Rodríguez-Villalba R, et al. Endoscopic reconstruction of large anterior skull base defects with opening of the sellar diaphragm. Experience at a tertiary level university hospital. J Laryngol Otol. 2019;133(10):889–94.

    Article  CAS  PubMed  Google Scholar 

  38. Raza SM, Schwartz TH. Multi-layer reconstruction during endoscopic endonasal surgery: how much is necessary? World Neurosurg. 2015;83(2):138–9.

    Article  PubMed  Google Scholar 

  39. de Angelis M, Cappabianca P. Gutta cavat lapidem: the reconstruction of the skull base after endoscopic endonasal surgery. World Neurosurg. 2015;83(2):136–7.

    Article  PubMed  Google Scholar 

  40. Kelly DF, Oskouian RJ, Fineman I. Collagen sponge repair of small cerebrospinal fluid leaks obviates tissue grafts and cerebrospinal fluid diversion after pituitary surgery. Neurosurgery. 2001;49(4):885–9. discussion 889–890

    CAS  PubMed  Google Scholar 

  41. Bhogireddy R, Krishnamurthy V, Sugin Lal Jabaris SL, Pullaiah CP, Manohar S. Is Mucormycosis an inevitable complication of Covid-19 in India? Braz J Infect Dis Off Publ Braz Soc Infect Dis. 2021;25(3):101597.

    CAS  Google Scholar 

  42. Honavar SG. Code mucor: guidelines for the diagnosis, staging and management of rhino-orbito-cerebral mucormycosis in the setting of COVID-19. Indian J Ophthalmol. 2021;69(6):1361–5.

    Article  PubMed  PubMed Central  Google Scholar 

  43. MohanaSundaram A, Thukani Sathanantham S, Chinchole V, Patil B, Velayutham R. Fostering a deeper understanding of COVID-19-associated mucormycosis—a commentary on “The mucormycosis coinfection in the context of global COVID-19 outbreak: a fatal addition to the pandemic spectrum” (Int. J. Surg. 2021:106031). Int J Surg Lond Engl. 2021;94:106110.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. SRM Medical College Hospital and Research Centre, SRMIST, Kattankulathur, Chengalpattu, Tamil Nadu, India

    Nitin M Nagarkar

  2. All India Institute of Medical Sciences, Raipur, Chhattisgarh, India

    Prajwal S Dange & Ambesh Singh

Authors
  1. Nitin M Nagarkar
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Prajwal S Dange
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ambesh Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. SRM Medical College Hospital and Research Centre, SRMIST, Kattankulathur, Chengalpattu, Tamil Nadu, India

    Nitin M Nagarkar

  2. Department of ENT, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India

    Rupa Mehta

  3. All India Institute of Medical Sciences, Raipur, Chhattisgarh, India

    Ambesh Singh

  4. All India Institute of Medical Sciences, Raipur, Chhattisgarh, India

    Karthik N Rao

  5. All India Institute of Medical Sciences, Raipur, Chhattisgarh, India

    Prajwal S Dange

Rights and permissions

Reprints and permissions

Copyright information

© 2023 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Nagarkar, N.M., Dange, P.S., Singh, A. (2023). Skull Base. In: Nagarkar, N.M., Mehta, R., Singh, A., Rao, K.N., Dange, P.S. (eds) Atlas of Head Neck and Skull-base Surgery. Springer, Singapore. https://doi.org/10.1007/978-981-99-6132-0_9

Download citation

  • DOI: https://doi.org/10.1007/978-981-99-6132-0_9

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-99-6131-3

  • Online ISBN: 978-981-99-6132-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation