Skull Base Surgery

The skull base is the borderline region separating the base of the brain and the extracranial structures. It is one of the most complex regions of the human body. Vital nerves and major blood traverse through tiny holes in the base of the skull making it a delicate area demanding precise skills for successful surgical interventions. Our multidisciplinary skull base team combines the expertise of multiple specialist including, the skull base surgeon, facial plastic and reconstructive surgeon, neurosurgeon, neurootologist, interventional radiologist, oncologist and rehabilitative therapists. Our experienced facial plastic and reconstructive surgeons work with Maryland skull base surgeons to bring optimal results from this complex procedure.

The skull base may be affected by a diversity of lesions:

• Vascular
• Neoplastic
• Congenital
• Traumatic
• Infectious

Example of common lesions includes:

• Benign Lesions
  • Pituitary adenomas
  • Schwannomas
  • Neurofibromas
  • Osteomas
  • Chordomas
  • Chondromas
  • Giant cell tumors
  • Fibrous dysplasia
  • Encephaloceles
  • Nasopharyngeal angiofibroma
  • Hemangiopericytoma
  • Large CSF fistulas
  • Petrous apex lesions

• Malignant Lesions
  • Gliomas
  • Olfactory neuroblastoma
  • Rhabdomyosarcoma
  • Chondrosarcoma
  • Metastatic cancer

In spite of their varied histology and biologic behavior, skull base lesions and defects have a common feature - they are difficult to reach and involve critical structures.

Combining our expertise in endoscopic surgery, facial cosmetic surgery, microsurgery, craniofacial surgery and head and neck surgery, our Maryland skull base surgeons are able to provide excellent approaches to skull base lesions. We employ minimally invasive approaches with endoscopes through the nose or through well hidden incisions that provide patients with quicker recovery without compromising their primary treatment outcome. Special forms of osteotomies are employed to provide access to deeply located skull base lesions while minimizing brain retraction and sometimes allowing preservation of olfaction which is commonly compromised in the classic craniofacial approaches. Common approaches performed include:

• Minimally invasive approach to orbital and paranasal tumors
• Endoscopic transnasal approaches to pituitary tumors
• Endoscopic approach to petrous apex lesions
• Minimally invasive approaches to infratemporal fossa tumors
• Subcranial approach to frontal sinus fractures