What is the Skull Base?
The skull base is the bottom portion of the skull that supports the undersurface of the brain and protects many vital structures. This area includes the roof of the eye sockets, cheek bone, top of the palate, the deep structures of the ear canals, and the bottom portion of the skull behind the head. The skull base contains 12 cranial nerves and multiple arteries that control complex senses, including hearing, vision, and balance.
Conditions and Disorders
The cranial nerves that occupy the skull base and the critical blood vessels that enter or exit the skull make the cranium one of the most delicate and complex organs of the human body. Common disorders that our neurosurgeons treat in this region include:
- Meningioma – tumor that develops from the meninges, the membrane that surrounds the brain and spinal cord
- Cavernoma (cavernous angiomas) – enlarged and irregular collection of small blood vessels in the brain or spinal cord
- Chondrosarcoma – cancer from cells that normally produce cartilage
- Clivus chordoma (rare) – slow-growing tumor near the clivus bone, located near the skull base
- Acoustic neuroma (vestibular schwannoma) – benign tumor that affects hearing and other cranial nerves, and the brain stem
- Brain stem tumors – array of different types of tumors that are located in the brainstem, the most vital part of the brain
- Epidermoid – congenital (present at birth) tumor that typically doesn’t present itself until adulthood
- Encephalocele – cerebral spinal fluid leak
- Esthesioneuroblastoma – tumor in the upper nasal cavity
- Glomus jugulare, jugular foramen, and petrous apex tumors – grow in the temporal bone region
- Pituitary tumors – tumors that affect the pituitary gland and cause endocrinological disorders and expand causing visual loss
- Facial nerve disorders
- Craniopharyngioma – benign tumor that expands, causing visual loss, hormonal disturbance, and growth abnormalities
- Temporal bone tumors and cancer – affects temporal bone and hearing apparatus
- Cranial nerve vascular compression – including hemifacial spasm and tic douloureux (trigeminal neuralgia), which causes severe pain on one side of face
- Arachnoid cysts – fluid-filled sacs located between the brain or spinal cord and the arachnoid membrane, one of three membranes covering the brain and spinal cord
- Craniovertebral junction disorder – a variety of neoplastic, traumatic, and congenital disorders that affect the junction between the head and the neck
- Bone infection
Diagnosis and Treatment
Our multidisciplinary skull base surgery team, using the latest imaging technology, is able to reach all areas of the skull base to treat a wide variety of cranial disorders. Our innovative surgical approaches for skull base disorders allow for faster pathological diagnosis, decompression of critical structures, and, often, a cure. Furthermore, our innovative surgical techniques – through the side or underneath the skull base – help minimize injury to the brain, resulting in a faster operation with fewer complications and a more timely recovery.
The surgical treatments we offer for skull base diseases include:
- Expanded endonasal endoscopic approaches (EEA) – minimally invasive procedures that use an endoscope to remove tumors through the nose
- Anterior craniofacial surgery – tumor is removed through the front of the skull base (near the hairline)
- Posterior skull base surgery – tumor is removed through the back or the side of the skull base
- Skull base radiosurgery – uses targeted radiation to reduce a tumor
- Vascular decompression – decompression procedure to treat trigeminal neuralgia or hemifacial spasm
To make an appointment or request a consultation, please contact the BWH Skull Base Surgery Program at: (617) 732-6600.