Update on skull base surgery.

The field of skull base surgery has changed significantly during the past decade. Various surgical approaches have been developed, which when used alone or in combination provide optimal exposure for the resection of a given lesion with minimal morbidity. This recent evolution in the field of skull base surgery has allowed the surgical management of larger lesions in previously inaccessible locations. Furthermore, techniques in the preoperative, intraoperative, and postoperative management of the intrapetrous internal carotid artery have circumvented many prior limitations of cranial base resections. The goals of this article are to provide an overview of the postlateral skull base approaches in use today, discuss the regions of the skull base that are accessible, and describe the state of the art in management of the intrapetrous internal carotid artery.