Anatomical principles of the lateral surgical approach to the skull base Several different surgical approaches have been employed in order to reach lesions in the rather inaccessible region of the skull base. However, it is the lateral approach that has recently become established as the approach of choice for most surgeons who work in this area. The main difficulty in creating adequate exposure has been the long, tortuous course of the facial nerve, which prevents direct access.
However, the technique of anterior transposition of the nerve demonstrated by Fisch (1977) has provided the access necessary for control of the internal carotid artery and internal jugular vein, and so has permitted satisfactory exploration of the skull base from the lateral approach. Fisch has developed three variants of this lateral approach, which he loosely terms the 'infratemporal fossa approach'. o The…
