The Cranial (Skull) Base Program deals with rare and complex tumors that were previously deemed inoperable due to their deep location behind the orbits, ears, or nasal cavity and sinuses. Fellowship trained specialists in neuro-otology, facial plastic surgery, skull base-neurosurgery, radiation oncology, medical oncology and allied health personnel make up the multidisciplinary team. Your records are reviewed prior to your appointment to facilitate the most efficient scheduling of all appointments, usually in a one day visit. The team evaluates the patient in the same room at the same time providing all treatment options, functioning as a “Traveling Tumor Board”. Patient care specialists are available to assist you with everything from transportation and lodging to coordinating all your appointments and local amenities.
Surgical approaches include: open, endoscopic assisted open, and computer guided endoscopic skull base surgery. All approaches are designed to restore the patient to his/her preoperative function and appearance. Over 1200 pediatric and adult skull base patients have been treated since the program began in 1994.
The most common lesion of the lateral cranial base is an acoustic neuroma (also called a vestibular schwannoma). Hearing loss can occur as a result of surgical tumor removal in these patients. Our team emphasizes hearing preservation whenever possible. We have been able to preserve hearing in 80% of our patients with small tumors. This success rate is the highest in the current medical literature Arts HA, Telian SA, El-Kashlan HE, Thompson BG: Hearing preservation and facial nerve outcomes in vestibular schwannoma surgery: Results using the middle cranial fossa approach. Otology & Neurotology 27:234-241, 2006.).
Deformities of the skull base can cause cerebrospinal fluid (CSF) leaks resulting in meningitis. Most of these patients are treated with minimally invasive endoscopic surgical repairs. Other skull base deformities that are congenital or resultant from trauma may cause facial disfigurement that requires the more extensive combined intracranial and extracranial correction. Our shorter length of post operative hospital stay (see chart) reduces patient’s exposure to hospital acquired complications.
Some skull base tumor patients may not require surgical treatment but rather radiation and/or chemotherapy and possibly only follow-up. State of the art radiotherapy or stereotactic radiosurgery deliver radiation to a target lesion with pinpoint accuracy.
It is with this team approach comprised of multiple specialties, that the highest quality and safest treatments can be offered to pediatric and adult skull base patients.