Surgical management of skull base osseous lesions: present challenges and future perspectives

Skull base osseous lesions, including various benign and malignant tumors, and developmental abnormalities like chordomas, osteomas, chondromas, osteosarcomas, fibrous dysplasia (FD), endolymphatic sac tumors, et al, are challenging to treat due to their deep anatomical location near critical nerves and vessels. Surgical treatment demands a balance between complete lesion resection and neural function preservation. In recent years, advances in endoscopy, imaging, intraoperative navigation, proton radiation therapy, and multi⁃disciplinary team (MDT) have led to continuous optimization of treatment strategies for skull base osseous lesions. This paper briefly reviews the current surgical strategies and breakthroughs for skull base osseous lesions.