Skull base surgery, also called skull base neurosurgery, is performed to remove growths and abnormalities, both benign and malignant, from the underside of the brain and the top few vertebrae of the spine. This area, known as the skull base, is one of the most complex to operate on because it is difficult to reach and is filled with many nerves that are responsible for hearing, seeing and facial movement. Additionally, the skull base is home to many blood vessels that supply oxygen to the brain and spinal cord.
A multidisciplinary team of neurosurgeons, ENT surgeons and many other specialists at Tampa General Hospital’s Neuroscience Institute and Ear, Nose and Throat Institute collaborate to perform skull base neurosurgery. As an academic medical center affiliated with the University of South Florida, TGH is uniquely positioned to implement the latest technological advances that lead to effective minimally invasive approaches to skull base surgery.
Our surgeons’ expertise, research and skill has helped TGH earn ranking among the top 10% of hospitals in the nation for Neurology & Neurosurgery by U.S. News & World Report for 2022-23.
What Conditions are Treated with Skull Base Surgery?
Skull base surgery is performed to remove tumors or other abnormalities from within the skull base region. As a result, there are many conditions that can be treated by skull base neurosurgery. Some of these include:
- Acoustic neuromas – Noncancerous tumors that form around certain nerves in the ear
- Sinonasal adenocarcinomas – Tumors that affect the sinuses and nasal cavities
- Adenoid cystic carcinoma – Tumors that grow in the salivary glands
- Pituitary adenoma – These tumors occur behind the nose and eyes and can cause acromegaly in adults
- Chordomas – Slow growing bone tumors generally found at the base of the skull
- Olfactory neuroblastoma – Tumors that develop in the upper region of the nasal cavity
- Brain aneurysm – A bulging spot in a blood vessel in the brain
- Arteriovenous malformations – Arteries and veins that are connected abnormally
- Trigeminal neuralgia – Severe pain on one side of the face
- Growths resulting from infections
Skull Base Surgery Procedures
There are two main approaches to skull base neurosurgery - endoscopic and open skull.
Endoscopic Skull Base Surgery
Endoscopic neurosurgery is minimally invasive and is performed through a small incision, usually in the nose. After the incision is made, an endoscope (a thin, lighted tube equipped with a small camera) is inserted into the incision and guided to the area of operation. A set of tiny surgical instruments then allows a surgeon to operate on areas that would otherwise be difficult to access. If a tumor is present, it can be removed and surgical openings are patched with mucosa from within the nose to seal cavities.
Open Skull Base Surgery
Although minimally invasive skull base surgery is the preferred method whenever possible, traditional or open base skull surgery is sometimes a patient’s best option. During traditional skull base surgery (craniotomy), incisions are made to the face and skull and pieces of bone are removed to allow the surgeon to access the intended area.
What to Expect with Skull Base Neurosurgery
After skull base neurosurgery, your medical team will closely monitor your progress. Patients who undergo minimally invasive skull base surgery often stay in the hospital for one or two days following the procedure. Those that undergo open skull base surgery may stay in the hospital for about one week. Most patients are typically able to walk the day after surgery and resume light exercises within a couple weeks.
Depending on the specific condition being treated, patients can expect to undergo one or more treatments in addition to skull base neurosurgery, such as vascular decompression, nerve stimulation, reconstructive and plastic surgery, radiation therapy and chemotherapy. For example, microvascular free flap surgery is often performed to address abnormalities in the bone or soft tissues surrounding the eyes and nose that can occur after skull base tumor removal surgery.
Other services, such as rehabilitation therapy and hearing and vision care may also be necessary.
Benefits of Skull Base Neurourgery
Patients who undergo skull base neurosurgery at TGH will benefit from world-class care delivered in a state-of-the-art facility. More specifically, minimally invasive skull base neurosurgery performed by experts from the Neuroscience and Ear, Nose and Throat Institutes allows for:
- No bruising
- No brain retraction
- A shorter hospital stay
- Less risk for cognitive decline
- Reduced risk for cerebrospinal fluid leaks in the brain
Become a Skull Base Surgery Patient
Learn more about TGH’s Center for Skull Base Surgery and find out if our approach to care if right for you. Call (800) 822-3627 to schedule an appointment.