Transmandibular Exposure of the Skull Base

The combined transmandibular-transcervical approach to the skull base ensures a wide field exposure to the lateral and midline compartments of the middle cranial fossa with attendant vascular control. Splitting the lip and mandible in the midline and dividing the floor of the mouth structures along the lateral border of the tongue exposes the parapharyngeal space, infratemporal fossa (lateral compartment), and clivus, nasopharynx, and cervical spine (midline compartment). A variety of benign and malignant intracranial and extracranial skull base lesions have been treated using this approach.