Transmandibular exposure of the skull base

Area of Science:

• Neurosurgery
• Head and Neck Surgery
• Skull Base Surgery

Background:

• Skull base surgery presents challenges due to complex anatomy and proximity to vital structures.
• Achieving adequate surgical exposure is crucial for effective treatment of skull base pathologies.

Purpose of the Study:

• To describe the combined transmandibular-transcervical surgical approach for skull base lesions.
• To highlight the anatomical exposure and vascular control offered by this technique.

Main Methods:

• The approach involves splitting the lip and mandible in the midline.
• Division of floor of mouth structures along the lateral tongue border.
• This provides access to the parapharyngeal space, infratemporal fossa, clivus, nasopharynx, and cervical spine.

Main Results:

• The transmandibular-transcervical approach ensures wide surgical field exposure.
• It allows for effective vascular control during skull base procedures.
• This technique facilitates treatment of both intracranial and extracranial lesions.

Conclusions:

• The combined transmandibular-transcervical approach is a valuable technique for skull base surgery.
• It provides extensive exposure to lateral and midline compartments of the middle cranial fossa.
• This approach is effective for managing a range of benign and malignant skull base tumors.