Endoscopic endonasal approaches (EEAs) have expanded beyond the transphenoidal pituitary surgery to become the best surgical corridors to manage benign and malignant processes along the entire ventral skull base and in selected cases within the cavernous sinus, suprasellar cistern, petrous region, and anterior craniocervical junction with similar or better results to those obtained with open procedures as well as with beneficial lower rates of complication. Using representative cases categorized by anatomic locations and endoscopic skull base surgical modules, we will discuss general principles, key skull base anatomy in relation to surgical access, the diversity of pathology, and the role of preoperative CT and MR imaging.The learning objective of the study was to use preoperative imaging criteria to identify lesions amenable to EEAs as well as those in technically challenging anatomic locations, posing high risks of neurovascular complications.Learning Objective: To utilize preoperative imaging criteria to identify lesions amenable to EEAs as well as those in technically challenging anatomic locations, posing high risks of neurovascular complications.
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