Skull Base Surgery

After your diagnosis is confirmed, you’ll meet a team of otolaryngologists, neurosurgeons, medical oncologists, radiation oncologists, and radiologists. They’ll work together and discuss your case at weekly meetings to determine what the best potential course of treatment is for your disorder. You should expect to undergo additional testing prior to receiving treatment.

Some pre-treatment work ups you may be required to undergo include:

• MRIs and CT scans
• Hearing and vision tests
• Swallowing tests
• Blood vessel imaging
• Laboratory testing, including blood tests

Once your medical team receives your pre-treatment work up results, all of your specialists will discuss your case at a multi-disciplinary conference and coordinate an individualized care plan that’s best for you. 

At BIDMC, we offer several treatments to resolve skull base problems, such as radiation, endovascular embolization, and surgery. 

Radiation: Radiation therapy is a treatment that relies on using radiation to shrink tumors and kill cancer cells. Though it can be a standalone treatment, it’s often used in conjunction with surgery. It’s administered by a team of neurosurgeons, oncologists, and medical physicists. Currently, we offer two types - CyberKnife radiation and external beam radiation. 

Endovascular Embolization: Endovascular embolization is a type of surgery used to treat blood vessels in and near the brain. The procedure is inpatient and typically requires one to two days of in hospital recovery. This type of embolization blocks the flow of blood to damaged areas of the brain. Like radiation, it can be a standalone procedure or precede an additional surgery. 

Skull Base Surgery: There are several surgical approaches to the treatment of skull base tumors that depend on the location of the tumor within the skull. This type of surgery involves removing certain areas of the skull base to access tumors without compromising neurological function. Your medical team will be available to answer any questions you may have regarding their recommended surgical approach. 

Keeping your individual needs in mind, our team of otolaryngologists and neurosurgeons will work together to present you with the best possible treatment options after assessing the results of your pre-treatment work ups. During this time, you’ll learn about the specific treatment options available to you and be given the opportunity to share any questions or concerns you may have.

Fortunately, many skull base problems are non-cancerous, so sometimes observation combined with regular follow ups is a reasonable management option. 

Skull base surgery can be used to treat a variety of disorders including:

• Brain defects
• Pituitary and olfactory tumors
• Nasal sinus tumors
• Benign tumors
• Acoustic neuromas: non-cancerous tumors on the nerve that leads from the inner ear to the brain
• Meningiomas: usually non-cancerous tumors that arise from membranes surrounding the brain and spinal cord
• Paragangliomas: rare tumors that begin in certain nerve cells in the body

Depending on location, skull base problems may produce a variety of subtle symptoms including hearing loss, imbalance, headaches, nasal problems, and/or changes in vision.  

Due to the complex nature of skull base surgery, you’ll spend your post-op recovery time in the intensive care unit (ICU). From there, you’ll start the rehabilitation process on the surgical floor.  

Rehabilitation services generally include:

• Nursing care
• Physical therapy
• Speech and swallow teams
• Occupational therapy

Most hospital stays range between 3-5 days, although that will vary depending on your progress. Additionally, you may require at-home services to help facilitate your recovery.

Potential at-home services you may require include:

• Physical therapy
• Vestibular therapy
• Audiology therapy
• Home health care

We also require several post-op follow up appointments with your skull base treatment team to ensure you recover fully after surgery.