(A) Minimally invasive is the core of surgery Skull base surgery has gone through three stages: traditional skull base surgery, microscopic skull base surgery and minimally invasive skull base surgery. Traditional skull base surgery uses extensive resection of the skull base bone to obtain exposure and remove the tumor as much as possible with less damage to brain tissue and neurovascular. Microscopic skull base surgery is based on traditional skull base surgery using microsurgical techniques to make it less invasive. The birth of the concept of minimally invasive skull base surgery is to reduce the surgical trauma while preserving the skull base approach and no longer blindly pursuing excessive removal of skull base bone. The surgery has evolved from complex to simple, and the treatment plan and the choice of surgical approach are individualized. Preoperatively, we use Dextroscope virtual reality technology to provide an intuitive three-dimensional anatomy, individualize the pathological anatomy, design a reasonable surgical approach, and develop an individualized treatment plan, thus improving the extent of tumor resection, reducing surgical injury and improving the quality of patient survival. In addition to operating under the microscope during the operation, for the area with narrow field of view, it can be combined with neuroscopic technology to make some residual tumors in the blind area of the operation be removed and the surrounding normal structures can be clearly understood. Endoscopic skull base surgery, which has undergone rapid development during the past decade, extends from suprasellar pituitary surgery to resection of C2 lesions via the sieve plate and pterygoid sinus to the skull base slope, up to the infratemporal fossa and rock tip on both sides. However, it is important to fully understand the endoscopic anatomy and skull base reconstructive surgery techniques. While benign lesions can be accomplished endoscopically, the management of malignant lesions remains a challenge and requires navigation systems, endoscopic imaging techniques, and robotics to continue active development in this expanding field. (II) Intracranial and extracranial communicating tumors should be multidisciplinary cooperation As specialists are familiar with different focus of skull base anatomy and pathological anatomy, and it involves damage of multiple sites, single-disciplinary treatment will have the consequence of losing both sides, multidisciplinary cooperation can detect and deal with corresponding complications in time, which can complement each other’s strengths and overcome the limitations of current disciplinary settings and make the surgery achieve the best results. (C) Focus on the selection of skull base reconstruction methods and materials Skull base surgery is a very important part of skull base surgery because of the damage to bone by tumor or surgery, resulting in the opening of brain tissue after surgery and complications such as cerebrospinal fluid leakage and intracranial infection. Materials commonly used for skull base repair include artificial meninges, titanium mesh, skin, mucosa, cartilage, fat, bone and fascia. A high success rate has been reported for small defects using these materials. For large defects, vascularized flaps such as cranial periosteal flaps, temporal flaps and free flaps must be used as reconstruction materials. The temporalis muscle transfer flap described in a recent report was reconstructed through the infratemporal fossa and pterygopalatine fossa, followed by microscopic placement of the flap. Cranial flaps can also be placed endoscopically into the nasal cranial base defect. Intraoperative use of real-time imaging and intraoperative ultrasound guidance will greatly improve the utility of current navigation systems in tumor resection. 3D endoscopy and reliance on virtual reality systems have been reported. Robotic skull base surgery is also in development, and it is not difficult to imagine an exciting spectacle with a systematic, highly agile operation of nasal endoscopic skull base robotic surgery. Skull base reconstruction is an important part of skull base surgery. The bony, dural and local soft tissue defects of the skull base left after skull base surgery increase the occurrence of postoperative cerebrospinal fluid leakage, intracranial and extracranial infections and brain bulge, and the selection of appropriate skull base reconstruction methods and repair materials for reliable and durable skull base reconstruction is an important guarantee of successful surgery. Allogeneic materials such as artificial dura mater (including biological and synthetic) and titanium mesh are abundant, not limited by the defect area and easy to shape, but the disadvantage is higher price. Autologous tissues are convenient and economical to obtain, but the disadvantages are limited source, not three-dimensional shaping, easy absorption and necrosis of transplanted tissue flaps, etc. The choice of skull base repair materials and methods can be decided according to the size and location of the defect, the individual patient and the wishes of the family. Artificial dura can be chosen to repair the dural defect and titanium mesh to repair the bony defect. A combination of autologous and allogeneic “sandwich” reconstruction, tipped tissue flap or free tissue flap can be chosen. For postoperative dead cavity, it can be filled with biomaterials or repaired with temporalis muscle flap to eliminate the dead cavity, reduce the infection rate, and establish a muscular barrier. The key to applying temporal muscle flap is to protect the superficial temporal artery and peel the temporal muscle from under the periosteum when stripping it. Currently, due to the application of minimally invasive concepts, complex and damaging skull base reconstruction is gradually decreasing, and due to the clinical application of neuroendoscopic technology, virtual reality and neuronavigation technology, the scope of surgery is reduced and the lesion is precisely localized, which reduces the incidence of skull base defects and the area of defects.