Dissection of the cranial base en bloc with the infratemporal fossa [Dissezione della base cranica in monoblocco con la fossa infratemporale.]

A high incidence of morbidity and mortality was related with skull-base neoplasm surgery. Several advances have permitted, in recent years, the total excision of such neoplasms with minimal patient morbidity. Due to an improved understanding of the surgical anatomy of the skull-base and to the collaboration of the neurosurgeon and maxillofacial surgeon and, moreover, to the improvements of imaging (CT and MR) in the past decades new combined approaches were planned and performed to allow en bloc resections of extensive lesions. Extensive exposure of the tumor, improved management of the internal carotid artery, preservation of cranial nerves not involved by tumors and improved cranial base reconstruction techniques (by free flaps) have resulted from this progress. The aim of the present work is to show the main anatomical landmarks of infratemporal fossa and medium skull base that help the surgeon to achieve an en bloc resection.