Nuances of the Surgical Management of the Paranasal and Ventral Cranial Base Malignancies: The Endonasal Endoscopic Approach

Introduction: Malignancies of the ventral cranial base can often extend into the sinuses, paranasal sinuses, orbit and extracranial fossa. As such, surgical management can be more difficult and often requires enhanced technical ability. Traditionally, two routes are employed to reach these tumors: (1) transfacial, cranial and craniofacial (combined) approaches, and (2) endonasal endoscopic approaches. Malignancies in the ventral cranial base often distort the nasal cavity making it difficult to locate the internal carotid artery (ICA), and an inadvertent damage could lead to serious complications.