What is Skull Base Surgery?

Skull base surgery may be done to remove both benign and cancerous growths, and abnormalities on the underside of the brain, the skull base, or the top few vertebrae of the spinal column. The skull is composed of bones and cartilage that form the face and the cranium, which surrounds the brain. You can feel the bones of the cranium on top of the skull. The five bones that form the bottom, or base, of the cranium also form the eye socket, roof of the nasal cavity, some of the sinuses, and the bones that surround the inner ear.

The skull base is a crowded and complicated area with openings that the spinal cord, many blood vessels, and nerves all pass through.  Because this is such a difficult area to see and reach, skull base surgery may be done by a minimally invasive endoscopic procedure in which instruments are inserted through the natural openings in the skull—the nose or mouth—or by making a small hole just above the eyebrow.

Who requires Skull Base Surgeries?

Skull base surgery may be required for:

  • Cysts that develop from birth
  • Growths caused by infections
  • Pituitary tumors
  • Chordomas
  • Trigeminal neuralgia
  • Craniopharyngiomas
  • Craniosynostosis
  • Cerebrospinal fluid fistulas

What are the types of Skull Base Surgeries?

Endoscopic or minimally-invasive skull base surgery.
This type of surgery usually does not require a large incision. An ENT surgeon may make a small opening inside the nose to allow a neurosurgeon to remove a growth through a thin lighted tube called an endoscope. An MRI is a type of picture taken of the skull base using magnets and a computer and may be done by a radiology specialist while the surgical specialists are operating to help them make sure all of the growth has been removed.

Traditional or open skull base surgery.
This type of surgery may require incisions in the facial area and in the skull. Parts of bone may need to be removed so that the growth can be reached and removed. An operating room microscope is often used for this type of surgery.

What is done after surgery?

After skull base surgery, you will be closely cared for by your medical team. Some people need continued therapy, and many will need repeated testing to make sure that a growth is not coming back over time. Because this type of surgery can be very stressful, it’s also important to get support from friends and family.