Fig.10. Different modifications of approaches to basal tumors, envisaging extended resection of the skull base bones.

A - an orbitozygomatic approach (according to Hakuba, 1986).
A diagram of formation of bone grafts and possible visual control of anatomic structures: dura mater is dissected, traction of temporal and frontal lobes is performed. One can see a free border of the cerebellum tentorium (1), the supraclinoid segment of ICA (2), the optic nerve (3), the olfactory tract (4), the eyeball, covered by dura mater (5), the Sylvian fissure (6).

B - an anterior transbasal approach (according to Derom, 1972; Samii, 1991; Al. Mefty, 1992; Sen et al., 1997; Sekhar, 1999).
The approach is performed between optical nerves, across the saddle fundus, clivus in the direction of the great foramen (1 and 2). Imaginary points of intersection of gaze lines can shift along the skull base to a distance of X1 and X2, depending on an anteroposterior size and form of the anterior cranial fossa. Main stages of an approach with extended resection of orbital roof are presented (3).

- lateral, dorsolateral and transcondylar approaches (according to Koose, 1985; Al. Mefty, 1988, 1993; Samii, 1992; Sekhar, 1999).
A combined transpyramidal approach (1). A zone of resection of a petrous part of the temporal bone pyramid is painted blue. Meningioma of the apex of the temporal bone pyramid is exposed (2). A diagram of a transcondylar approach (3). Suboccipital craniotomy is supplemented by resection of the great foramen margin and occipital condyle.