The Cervicopterygoidal Approach to the Central Skull Base

The surgical approach to the central skull base with surrounding nerve and vascular structures is difficult. While the endonasal approach is limited by the lateral bony and vascular sturctures, extended exposure via the transfacial or lateral route is associated with significant morbidity.

Thus, for resection of central skull base tumors and tumors of the pterygoid fossa, we have developed a new surgical technique: the cervicopterygoidal approach. This approach is to be performed as a combined microendoscopic procedure and therefore offers an ideal compromise of excellent exposure and relatively few side effects. We have used this approach successfully in several cases. Within the video our surgical concept is demonstrated during an anatomical dissection.

In conclusion, the indications for this new technique are (1) (even large) benign tumors in the pterygoid fossa and the nasopharynx and (2) well-defined malignant tumors such as recurrent nasopharyngeal tumors after radiotherapy.