About Skull Base Surgery

What is the skull base?

The skull base, or cranial fossa, is an area of the skull that supports the brain.

This area contains critical and complex anatomy, including blood vessels that provide essential nutrients, nerve pathways, and many other important functional structures.  The skull base is divided into the anterior, middle, and posterior regions. Tumors and other disorders can occur in any of these regions, disrupting and impeding normal function.  Depending on the tumor location, size, and type, the structures involved may be very limited, or they may include the bottom of the brain, the nasal cavity and sinuses, the orbits (eyes), the ears, the throat, and the neck, in addition to the nerves and blood vessels that support those structures.  Columbia University’s Skull Base Surgery Team is comprised of internationally recognized experts in the diagnosis and management of these lesions.

What is a skull base tumor?

A skull base tumor is a broad diagnosis for any mass that develops in any region of the skull base.  Some skull base tumors may be present for years and are identified incidentally when doctors are looking for other things.  Other skull base tumors may grow rapidly and cause severe symptoms.  Skull base tumors usually involve more than one important anatomic structure.

The symptoms of skull base disorders vary depending on the location, size, and type of the problem.  Some skull base disorders do not cause any symptoms.  Others may cause headache, visual changes or double vision, nasal obstruction, persistent runny nose (typically one sided), loss of sense of smell, facial pain, or swelling.  Imaging studies, including computed tomography (CT) scans and magnetic resonance imaging (MRIs) are typically required to understand the nature of the skull base problem. 

Every patient with a skull base tumor should be carefully evaluated to develop an individualized treatment plan with the patient and Columbia University’s multidisciplinary Skull Base Surgery Team.  Many skull base disorders do not require treatment at all and can be carefully observed with repeat imaging studies over time.  Other skull base disorders may require a combination of treatment strategies. 

What is skull base surgery?

Skull base surgery is a highly specialized targeted surgery to access the base of the skull to correct a defect, remove a tumor, and perform a functional reconstruction. Since the skull base involves crtitical structures that overlap several types of surgical subspecialists, skull base disorders are generally managed with a team approach.  The Columbia University Skull Base Surgery Team is comprised of internationally recognized experts with extensive experience working together to treat these kinds of problems.

Endoscopic Skull Base Surgery

Endoscopic skull base surgery is a revolutionary modern approach to access the skull base using small endoscopes, usually through the nose.  Extensive data, including our own, has demonstrated numerous advantages of endoscopic skull base surgery rather than traditional craniotomy surgery for tumors at the bottom of the brain.