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• Part I General Principles
1 Evolution of the Multidisciplinary Skull Base Team 3
2 Surgical Anatomy of the Cranial Nerves . 9
3 Skull Base Compartmental Anatomy: Microsurgical and Endoscopic 35
4 The Operating Room . 61
5 Surgical Positioning 71
6 Cranial Nerve Functional Preservation: Tricks of the Trade . 81
7 Neurophysiologic Monitoring 89
8 Microdissection Tools . 101
9 Neuroimaging Precision Tools and Augmented Reality 105
10 Skull Base Reconstruction . 131
11 Role of Radiotherapy in Modern Skull Base Surgery . 147
12 Cerebral Revascularization for Skull Base Lesions . 157
13 Cranial Nerve Repair and Rehabilitation . 169
• Part II Anterior Cranial Fossa
14 Anterior Fossa Pathology: Open Surgical Approaches 197
15 Endoscopic Endonasal Approaches 215
16 Anterior Fossa: Eyebrow Keyhole Approach 229
17 Meningioma . 237
18 Craniopharyngioma 251
19 Pituitary Adenoma . 271
20 Sinonasal Cancer . 289
• Part III Orbit
21 Orbital Tumors 303
• Part IV Middle Cranial Fossa: Cavernous Sinus
22 The Cavernous Sinus: Surgical Approaches—Endoscopic and Open . 331
23 Cavernous Sinus Meningioma 347
24 Pituitary Adenoma . 365
25 Schwannoma 377
26 Chordomas and Chondrosarcomas Involving the Cavernous Sinus 391
• Part V Middle Cranial Fossa: Meckel’s Cave
27 Open Surgical Approaches to Meckel’s Cave 407
28 Endoscopic Endonasal Approach to Meckel’s Cave 415
29 Trigeminal Schwannoma 421
• Part VI Intracanalicular Vestibular Schwannoma
30 Middle Fossa Approach for Hearing Preservation437
• Part VII Retrosellar Region
31 Expanded Middle Fossa Approach: The Extradural Anterior Petrosectomy 453
32 The Pretemporal Transcavernous Approach 465
33 Endoscopic Endonasal Transcavernous Approach . 475
• Part VIII Posterior Fossa
34 Open Surgical Approaches to the Posterior Fossa 487
35 Endoscopic Endonasal Transpterygoid Approaches to the Posterior Fossa 501
36 Keyhole Approaches to the Posterior Fossa . 513
37 Petroclival Meningiomas 523
38 Vestibular Schwannomas 551
39 Cerebellopontine Angle Epidermoid Tumors 569
40 Chordomas and Chondrosarcomas of the Posterior Fossa . 581
41 Pineal Tumors . 603
42 Brainstem Cavernous Malformations 621
43 Cranial Nerve Hyperfunction Syndromes With and Without Vascular Compression and Tumor 635
• Part IX Jugular Foramen Region
44 Open Surgical Approaches to the Jugular Foramen 649
45 Endoscopic Endonasal Approaches to the Jugular Foramen . 659
46 Jugular Foramen Meningiomas . 677
47 Jugular Foramen Schwannomas 689
48 Paraganglioma . 701
49 Chondrosarcoma . 717
• Part X Infratemporal Fossa
50 Open Approaches “Preauricular Transcranial Infratemporal Fossa Approaches for Radical Resection of Tumors in or Around Infratemporal Fossa” . 731
51 Endoscopic Endonasal Approaches to the Infratemporal Fossa . 747
52 Surgery of Paraganglioma . 755
53 Juvenile Nasopharyngeal Angiofibroma . . 771
54 Schwannoma 781
• Part XI Petrous Bone
55 Cholesterol Granulomas and Endolymphatic Sac Tumors . 795
Index . 807

This text is designed to function as a comprehensive guide/companion that will not only facilitate the decision-making process for the surgeon, but also help young surgeons build a successful career in skull base surgery. It is divided into six main sections:
The first section details the general principles that every skull base surgeon needs to be acquainted with - skull base anatomy, developing a multidisciplinary skull base team, operating room equipment, surgical instruments, and modern imaging technologies. These are the key elements that play a major role in optimizing functional outcomes and patients’ quality of life. Following this, the compartmental anatomy chapters set the stage for understanding the technical and surgical nuances of each location.
The subsequent five sections are organized as anatomical compartments or regions of the skull base. Every region is organized in the same format for uniformity and ease of use. Each section includes the available treatment choices to each compartment, and describes the relevant pathologies. The contribution of worldwide leaders including neurosurgeons and otolaryngologists provides top-level expertise in how to tackle each pathology.The surgical approaches chapters that lead each anatomical section describe operative techniques in a clear. stepwise fashion with accompanying intra-operative photos and surgical videos. In the individual pathology chapters, different pathological subtypes are described with representative radiographic images of clinical case examples. Accompanying each pathology is a treatment algorithm based on tumor morphology, pre-operative clinical status, and the goal of maximum functional preservation with a brief description of surgical approaches. This will serve as a roadmap that will help the reader to easily reach a decision of how to treat each skull base pathology.
The general theme is functional and anatomical preservation of key neurovascular structures. Setting such structures as a target and planning an approach that minimizes iatrogenic damage to these structures will lead the surgeon down the road of either open, endoscopic, or a combination of both approaches.
A comprehensive book that is versatile to serve as a handbook as well as a detailed reference for skull base surgery does not currently exist. In addition, combining the two main surgical schools represented by endoscopy and open surgery into one reference enhanced by treatment algorithms is another unique feature.

• Inclusive of both open and endoscopic approaches to the skull base
• Operative techniques described in a clear. stepwise fashion
• Written by experts in the field

Dr Youssef completed his neurosurgery residency at the prestigious Ain-Shams University in Cairo, Egypt. He completed his residency in 2001 during which time he was able to complete a PhD in the Neurosciences through a joint program with Hahnemann University in Philadelphia. Dr Youssef also completed a two-year pediatric neurosurgery fellowship at Hahnemann University during the mid-portion of his neurosurgical training. Following graduation, he completed two fellowships in skull base surgery, the first at the University of Cincinnati from 2001-2002 and the second at the University of South Florida from 2002-2003, which included a fellowship in cerebrovascular surgery as well. With a desire to continue his medical career in the United States he entered into a second neurosurgical residency at the University of South Florida. He completed this residency in 2008 and joined the department for 6 years as a faculty member at the University of South Florida, rising from the rank of Assistant to Associate Professor. Dr Youssef joined the Department of Neurosurgery at the University of Colorado as director of the skull base program in June of 2014. Currently he’s a Professor of Neurosurgery and Otolaryngology and Fellowship program director. He is vice chairman for education and director of the skull base surgery program.

He holds patents covering both novel surgical techniques and instrumentation for complex skull surgery. The Youssef Cranial Nerve Dissector set is another addition to comprehensive skull base instrument sets. His research both in the laboratory and in the operating room have resulted in multiple publications and patents. He is the author of over 100 publications including peer-review, abstracts and book chapters. Dr Youssef has given over 150 presentations nationally and internationally.
Dr Youssef’s interest is in the combined endoscopic and microsurgery techniques to further develop lesser invasive surgery in our field.