The cranial base was regarded as surgically unapproachable in the past because of the anatomic complexity and vital importance of the structures within its boundaries. However many incremental advances have been made in head & neck surgery and other related fields, which have helped to overcome these obstacles, making surgery of the cranial base both technically feasible and therapeutically effective. By using the midfacial split approach, the exposure of nasal cavity, paranasal sinuses, anterior & middle the cranial base as well as 1st, 2nd cervical spine, sella, and clivus are easily made. The midfacial split approach allows one to better observe the anatomic complexity of the region and the diversity of lesion found there, while also allowing for easier surgical access. Recently the authors obtained the successful treatment results in patients with malignancy of both the ethmoid sinus and sphenoid sinus and pleomorphic adenoma of nasal cavity using both the midfacial split approach and facial translocation approach.