FACIAL TRANSLOCATION APPROACH TO THE CRANIAL BASE - THE ANATOMIC BASIS

Surgical exposure of the nasopharyngeal region of the cranial base is difficult because of its proximity to key anatomic structures. Our laboratory study outlines the anatomic basis for a new approach to this complex topography. Dissections were performed on eight cadaver halves and two fresh specimens injected with intravascular silicone rubber compound. By utilizing facial soft tissue translocation combined with craniofacial osteotomies, a wide surgical field can be obtained at the skull base. The accessible surgical field extends from the contralateral eustachian tube to the ipsilateral geniculate ganglion, including the nasopharynx, clivus, sphenoid, and cavernous sinuses, the entire infratemporal fossa, and superior orbital fissure. The facial translocation approach offers previously unavailable wide and direct exposure, with a potential for immediate reconstruction, of this complex region of the cranial base.