Surgical Anatomy of Endoscopic Endonasal Approaches to the Anterior Cranial Fossa

Abstract

Lesions of the anterior cranial fossa (ACF) are challenging to treat. Historically, to obviate retraction on the frontal lobes and access the entire lesion, extensive craniofacial and skull base approaches were employed, often leading to significant cosmetic defects and morbidity. With the advent of expanded endonasal approaches, select lesions involving the ACF are treated with endoscopic endonasal approaches (EEAs). Consequently, for the contemporary skull base neurosurgeon, understanding the anatomy of EEAs to ACF lesions is vital. Thus, in this article we detail the surgical anatomy of EEAs to the ACF.