Skull Base Surgery

The skull base is the bottom part of the skull. Every nerve in the body that carries signals to and from the brain crosses the skull base. The skull base also houses large vessels that carry blood to and from the brain.

Skull Base Tumors and Conditions We Treat

The Children’s Hearing Center diagnoses and surgically treats the following skull base tumors:

  • Benign tumors
    • Acoustic neuroma
    • Meningioma
    • Schwannoma
    • Glomus jugulare and vagale
    • Epidermoid
    • Pituitary tumors
  • Malignant tumors
    • Squamous cell carcinoma
    • Esthesioneuroblastoma
    • Chondrosarcoma
    • Chordoma
    • Endolymphatic sac tumors

Surgery may also be performed to:

  • Repair fractures
  • Treat cerebral aneurysms
  • Remove infections
  • Diagnose a disease (biopsy)

Neurofibromatosis Type II (NF2)
Patients with neurofibromatosis type II have a gene mutation that causes multiple benign tumors. Ninety percent of NF2 patients become deaf.
 
We perform microsurgery to remove the tumors. This requires a high-powered microscope, delicate instruments, and special computers.

 

Evaluation of Skull Base Tumors

Magnetic resonance imaging (MRI) of the brain and/or skull helps us diagnose skull base tumors. A computed tomography (CT) scan of the skull base or temporal bone may also be needed. A magnetic resonance angiogram (MRA) and magnetic resonance venogram (MRV) may also help our team understand how the blood vessels to the brain are affected.

 

Treatment of Skull Base Tumors

Not all skull base tumors require treatment. Some are slow-growing and pose little risk to your child’s health.
 
If your child’s tumor requires treatment, your child’s health care team will include specialists from oncology and radiation oncology. Together, we work to provide an effective surgical treatment and to give your child the best chance for healthy growth, development and daily function after surgery. 
 
For large or very vascular tumors, an angiogram with embolization may be done before surgery. This helps to plug the arteries that feed the tumor and reduces blood loss during surgery.
 
Stereotactic radiation. A computer-guided system, called the Cyberknife, focuses very accurately targeted, large doses of radiation on the skull base tumor. The radiation does not remove the tumor, but does reduce or stop its growth.
 
This treatment also minimizes the radiation dose to the healthy tissue surrounding the diseased area. This is especially important for your child’s developing brain.
 
Stereotactic radiation is a noninvasive treatment. No instruments are inserted into your child’s body.