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Skull Base Surgery

Skull base surgery is used to treat sinus and skull base tumors as well as other abnormalities near the bottom of the skull, including the following:

  • Acoustic neuroma (also known as vestibular schwannoma)
  • Birth defects that affect the skull, including encephalocele
  • Cancer involving the base of the skull and ear
  • Cerebrospinal fluid (CSF) leaks through the nose or ear (also known as CSF rhinorrhea and CSF otorrhea, respectively), which is when spinal fluid leaks from tears in the tissue around the brain
  • Cholesterol granuloma and other types of cysts (fluid-filled sacs)
  • Chondrosarcoma
  • Chordomas
  • Facial nerve tumors, including facial nerve schwannomas and hemangiomas
  • Fibro-osseous lesions (osteoma, fibrous dysplasia, ossifying fibroma), which occur when scar tissue weakens and deforms bone in the bottom of the skull
  • Hemifacial spasms
  • Infections that affect the skull, including osteomyelitis
  • Meningiomas of the brain, skull base and juglar foramen
  • Paragangliomas, also known as glomus tumors, which can form in the jugular foramen
  • Paranasal sinus and nasal cavity cancers (esthesioneuroblasoma, squamous cell carcinoma, adenocarcinoma, sinonasal undifferentiated carcinoma, adenoid cystic carcinoma, melanoma, basal cell carcinoma, sarcoma, lymphoma)
  • Paranasal sinus and nasal cavity benign tumors (inverted papillomas, juvenile nasopharyngeal angiofibromas)
  • Pituitary tumors
  • Trigeminal neuralgia

These surgeries can be intricate because the skull base is near the brain, eyes, ears, and major blood vessels and nerves. The team approach to treatment at the Rush Center for Pituitary and Skull Base Surgery — which involves ear, nose and throat surgeons, neurosurgeons and other clinicians — means patients benefit from the collective expertise of multiple specialists.

What are the symptoms of skull base problems?

A variety of symptoms are associated with skull base problems, depending on the size and location of the growth or malformation:

Clear drainage from the nose or the ears

If you experience any of the above symptoms, see your primary care doctor. You may be referred to an ear, nose and throat specialist if your doctor suspects a tumor or other abnormality. 

Types of skull base surgery

As a leading referral hospital, Rush sees some of the most complex patients in the region. Because our surgeons regularly perform delicate skull base procedures, they have the experience to handle the most complex cases.

  • Endoscopic skull base surgery: Many skull base surgeries at Rush are performed minimally invasively. Endoscopic surgeries are performed through the nostrils, or via a tiny incision in the scalp. Using a nasal endoscope — a thin tube with a tiny video camera — surgeons can remove or fix many skull base abnormalities. 
  • Traditional skull base surgery: In some cases, open surgery is necessary. Surgeons perform the operation through an incision in the face or skull. 

Depending on the problem, you may need other treatments before or after surgery. These might include the following:

  • Chemotherapy: Chemotherapy uses drugs to speed up the death of cancer cells or stop them from duplicating.
  • Targeted, or directed, therapy: These drugs are designed to attack specific genetic mutations in cancerous tumors.
  • Immunotherapy: These promising treatments, which help the body’s immune system attack cancer cells, can help some patients with skull base tumors. 
  • Radiation therapy: Rush deploys the TrueBeam STx system to deliver a single high dose of radiation to a tumor. Known as stereotactic radiosurgery, this highly targeted approach reduces treatment time and minimizes damage to healthy surrounding tissue

Why choose Rush for skull base surgery

  • Precision surgery: ENT surgeons and neurosurgeons at Rush use the latest in computer imaging, based on CT and MRI scans, to zero in on the location of the tumor or abnormality. This allows them to operate more precisely and minimize damage to healthy tissue.
  • An emphasis on quality of life: In addition to addressing your surgical and medical needs, the multidisciplinary team at the Rush Center for Skull Base and Pituitary Surgery ensures you get the physical therapy, speech therapy, nutrition services and other supportive care you need to have the best quality of life possible.
  • Nationally ranked programs: Rush's neurology and neurosurgery programs are ranked among the best in the nation by U.S. News & World Report.