A conceptual approach to learning and organizing the surgical anatomy of the skull base

The surgical anatomy of the skull base is often considered to be complicated. In order to devise a system for organizing the various anatomical relationships into a learnable package, 20 skull base dissections were performed on preserved specimens. The findings from the dissections indicate that it is possible to organize the relationships into a three-dimensional set of coordinates that interrelates nearly all the important structures of the parapharyngeal area of the skull base. This system consists of three vertical and three horizontal planes. It uses the temporomandibular joint (TMJ) as a landmark and as an access pathway to the system. Additionally the findings from the dissections indicate that the classical concept of the parapharyngeal space is not accurate when applied to the skull base.