Cosmetic considerations in cranial base surgery.

Recent advances in the surgical techniques for the resection of cranial base tumors have allowed for improved degrees of tumor resection, functional outcomes, and esthetic results. If the resection and functional results are not compromised by procedures providing excellent cosmetic outcomes, there is no reason to ignore or compromise the esthetic aspect with regard to technical execution and planning. A thorough assessment of the patient's preoperative deficits and tumor anatomy and a working knowledge of the available cranial base approaches and their combinations permit the surgeon to design an approach that allows for optimal tumor resection with the best possible cosmetic result. In a time when alternative treatment options like radiosurgery exist for cranial base tumors, esthetic outcome is a significant quality-of-life issue that patients consider in their decision to choose surgery versus an alternative treatment.