Executive Editor: Daniel Buchbinder General Editor: Daniel Buchbinder

Authors: S Fusetti, B Hammer, R Kellman, C Matula, EB Strong, Co-author: A Di Ieva

Skull base & Cranial vault

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Soft-tissue injuries can be used to directly access fracture sites for fracture management.

Coronal approach

Coronal approach

The coronal or bi-temporal approach is used to expose the anterior cranial vault, the forehead, and the upper and middle regions of the facial skeleton.

Lateral skull base approach

Lateral skull base approach

With the lateral skull base approach the lateral anterior and the middle cranial fossae can be reached. The lateral skull base approach is generally the approach of choise to repair CSF leak associated with lateral skull base trauma.

Posterior skull base approach

Posterior skull base approach

When wide visualization of the medial canthal area, lacrimal sac, and medial orbital wall is needed an extended glabellar approach is advantageous.

Transmatoid approach for facial nerve decompression

Transmastoid approach

The transmastoid approach is used for facial nerve decompression. A postauricular incision is commonly used to access the mastoid.

Endoscopic transnasal approach to the frontal sinus

Endoscopy: Transnasal

Endoscopic sinus surgery techniques can be used to open the frontal recess from below.

Endoscopic approach to the central (anterior) skull base

Endoscopy: Central skull base

The whole central compartment of the skull base, from the crista galli to the clivus and anterior craniocervical junction, can be accessed by means of the endonasal transsphenoidal endoscopic approach.

Endoscopic approach to the anterior table

Endoscopy: Anterior table

Endoscopy has a variety of potential uses for frontal sinus fractures. Endoscopic access is most favorable in the upper portion of the frontal sinus.

v1.0 2011-05-14