[Apropos of the infratemporal pre-auricular approach (its value in the approach to the midline skull base].

The role of the infratemporal pre-auricular pathway to the median base of the skull resides in the fact that it enables very wide access to this region while sparing the facial and auditory nerves. Among the operations performed on the approaches of the base of the skull by their teams, the authors chose a particularly typical observation dealing with the indication of this pathway: a 34-year old male with a giant cholesteatoma of the tip of the petrous bone totally surrounding the internal carotid artery along its entire (intrapetrous) length, from the cervical region to the cavernous sinus, having invaded the clivus and pushed back the brainstem. This lesion is located on the side of the only healthy ear. The patient is completely deaf in the ear on the other side. The operation enabled its complete exeresis while respecting the facial, auditive and vestibular functions.