Subtemporal-infratemporal and basal subfrontal approach to extensive cranial base tumours

A subtemporal-infratemporal and basal subfrontal approach for the removal of extensive, predominantly extradural cranial base neoplasms is described. This approach was used successfully in six of our patients. The advantages of this approach are extensive exposure of the anterior and mid-cranial base as well as the clivus, direct exposure and management of the ipsilateral petrous and cavernous internal carotid artery (ICA), and access to extracranial vessels for microvascular flap transfer. Disadvantages include prolonged operative time and less control of the contralateral petrous ICA. Six patients with extensive cranial base neoplasms had operations using this technique without any mortality or major permanent morbidity. The value of this approach to patients in terms of control or cure of extensive cranial base tumours has to be proven by long term follow-up.