What is skull base surgery?

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?

Highly trained Rush surgeons access the structures of the skull base via three methods:

• 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).

What instruments are used during skull base surgery?

A variety of specially designed, highly flexible fiberoptic endoscopes are used to visualize the area. The surgeon may use traditional surgical instruments and/or lasers to perform the needed procedure through one or more of the above-mentioned openings.

Who performs skull base surgery?

Because the underside of the brain involves many complex structures including the pituitary gland, vital blood vessels and major cranial nerves, 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)