BACKGROUND: A surgical and anatomic approach to the skull base using the transmaxillary route is presented. This route is well-known and used for a long time for sinus conditions.
METHODS: This study was performed on injected cadavers. This study describes step by step this approach in microsurgical conditions following a vital lead: the infraorbital nerve.
RESULTS: Anatomical landmarks are located in order to avoid complications. These complications are on one hand, hemorrhages by vascular lesions and on the other, definitive nerve palsy.
CONCLUSIONS: Several skull base approaches exist, transfacial routes produce cosmetic damages. This route preserves the functional anatomy of the nose because it preserves the integrity of the lateral wall of the nasal cavity.

Cranial base fractures still represent a challenging issue. A multidisciplinary approach and the contribution of different specialists is mandatory. There is still a controversy regarding the correct approach to these trauma due to the diversity of opinions as well as surgical approaches and timing.