General Principles

Figure 1: Skull base and AVM surgery continue to challenge the precision, persistence, surgical fitness and ultimately operative talent of the surgeon.  I consider the moment of meditation before a challenging operation an important element in surgical preparation.  I realize that my faith in God (Hashem/Adonai) plays an important role in my operative success during the life-threatening and transformative moments in surgery. The operating room is the temple where our sacred entity (the patient) is the only center of attention. Skull base neurosurgery has emerged over the past 25 years as a subspecialty of neurological surgery concerned with surgical management of neoplastic and vascular lesions around the cranial base.  Expanded skull base osteotomies and endoscopic transnasal surgery have revolutionized cranial base surgery and will continue to evolve.  Their balance will affect our philosophy for managing complex cranial base tumors. The skull base with its complex bony anatomy a...

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