Surgery has become a routine procedure for management of neoplasms arising in the skull base and paranasal sinuses. The main objective in skull base surgery is ablation of the tumor while minimizing morbidity and preserving the patient’s quality of life. Decisions regarding the goals of surgery are made according to factors involving the tumor and the patient. Tumor-related factors include histology, tumor size, extension, differentiation, and the presence of locoregional or distant metastases. Patient-related factors include, age, sex, family history, previous operations, and prior radiotherapy. Many of these surgeries require multidisciplinary treatment by otolaryngologists, neurosurgeons, and plastic surgeons.

To allow safe ablation of the tumor with minimal morbidity, the operating room (OR) setup should be arranged accordingly. This chapter describes in detail the OR setup as practiced by the authors for both open and endoscopic operations.