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Combined skull base approaches have become increasingly popular to address intracranial and head and neck lesions. Improved endoscopic visualization, endoscopic tools, and surgical techniques have allowed safer and more ready access to difficult regions in the skull base. Historically, the parapharyngeal space and infratemporal fossa have been considered distinct locations in the head and neck that have been a challenge to access. This chapter details endoscopic endonasal, transoral, and transcervical approaches, along with a review of general indications, utility, and microsurgical anatomy.
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