Lesions involving the middle cranial base, its underlying volumes, and the first cervical vertebrae can be adequately managed surgically by means of a series of different approaches. These have the following basic prerequisites: to supply adequate surgical light, to identify and preserve the neurovascular structures adjacent to the lesion, to restore an adequate barrier between the neurocranium and the upper aerodigestive tracts, and to preserve both the functionality and the appearance of the patient. © 2010 Springer-Verlag Milan.
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