Lateral middle skull base is a complex territory and varies in their pathology. Surgery of the skull base is a challenging to neurosurgeon and ENT surgeon. The improvement of endoscopy has expanded the reach of sublabial transmaxillary approach. This approach can be an alternative method to remove the lesion with less morbidity, improved cosmetic outcomes. A study of 11 cases of lateral middle skull base which presented at our tertiary care hospital . Data of their examination, radiology (digital substraction angiography (DSA), computerized tomography (CT) and magnetic resonance imaging (MRI)), postoperative complications and definitive histopathology. All of patients underwent endoscopic sublabial transmaxillary approach and were followed for 1 year. The tumors composed of meningoma (n=2), ossifying fibroma (n=1), chondrosarcoma (n=1), soft tissue sarcoma (n = 2), plasmacytoma (n=2), non-hodgkin lymphoma B cells (n=1), inflammatory tissues (n = 2). Postoperative complications were facial numbness, trismus in two cases. No CSF leakage was detected. Endoscopic sublabial transmaxillary approach (ESTA) is an attractive alternative route for the treatment of lateral middle skull base tumor. This provides an excellent exposure, good surgical freedom and obviates the morbidity, mortality.

Keywords: Skull base surgery, Endoscopic sublabial transmaxillary approach, infratemporal fossa, pterygopalatine fossa, maxillofacial surgery