Introduction:

Endoscopic Keyhole surgery for cranial base tumors represents a philosophical evolution of neurosurgical thinking from great craniotomies to small ones with controlled drainage of cerebrospinal fluid. Objectives: to describe theorical concerns that support Keyhole approaches and present the results of the case series.

Method:

A descriptive study was performed in 56 patients with skull base tumors operated on by Keyhole surgery in the anterior, middle and posterior fossa. The tumoral resection, clinical evolution and main complications were determined. Global visualization and global maneuverability areas were described, such as its determinant and influential factors.

Results:

A high total tumor resection rate of over 85% was achieved with minimal complications; a significant facial nerve restauration in retrosigmoid Keyhole and satisfactory cosmetic results in supraorbital Keyhole were obtained. Conclusions. Keyhole surgery based on physical, mathematical and biomedical laws constitutes an excellent and promising surgical philosophy.

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