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UR Medicine / Neurosurgery / Services / Treatments / Skull Base Surgery


Skull Base Surgery

For more information, please visit our Comprehensive Brain & Spinal Tumor site or the Multidisciplinary Neuroendocrine Program or our Cerebrovascular, Stroke and Endovascular Program site

What is it?

Skull base surgery is a highly specialized, minimally invasive surgical technique for evaluating, diagnosing and treating benign or cancerous growths located on the underside of the brain, the base of the skull and the upper vertebrae of the spinal column. It can also be advantageous in repairing congenital anomalies and malformations.

Skull base surgeons use special instruments inserted through the skull’s natural openings (e.g., nose, mouth and above the eyes) to operate rather than accessing the brain through a craniotomy (surgical opening of the skull). Prior to the development of skull base surgery it was necessary to remove relatively large portions of the skull and/or facial musculature in order to gain entry into these areas. The benefits of skull base surgery include less risk of infection and damage to cerebral structures and nerves, less risk of disfigurement and a shorter recovery time.

How is the skull base accessed?

Commonly used approaches include:

  • Trans-nasal: entering through the nostrils
  • Trans-oral: entering through the mouth
  • Supra-orbital: entering just above the eyebrow (necessitates a small, half-inch opening into the skull)

Who performs skull base surgery?

The bottom of the skull involves many complex structures including the brain, vital blood vessels and many important nerves from brain to control the head and facial functions. The surgery at this location carries significant risks, a multi-disciplinary team of specially trained surgeons collaborates to perform skull base surgery. Depending on the diagnosis, the team may include an otolaryngologist, a neurosurgeon, and a radiation oncologist. Maxillofacial surgeons and plastic and reconstructive surgeons may also be consulted as well as pediatric specialists when the surgery involves children.

What conditions can be treated using skull base surgery?

A partial list of conditions that may be treated using skull base surgery includes:

  • Pituitary tumors
  • Meningiomas
  • Chordomas
  • Trigeminal neuralgia
  • Vestibulocochlear nerve disorders
  • Craniopharyngiomas
  • Hemifacial spasms
  • Craniostenosis
  • Cerebro-spinal fluid fistulas
  • Cerebral aneurysms
  • Arteriovenous Malformations (AVMs)