Skull Base Surgery

Our approach to skull base surgery

When you need skull base surgery, the two pillars of our care are:

• staying patient-centered, and
• working within a powerful multidisciplinary team

Your patient experience is as important to your health as an accurate diagnosis and great treatment. We look at you holistically, taking your preferences, life circumstances and post-surgical support systems into account.
 
Surgery can be daunting. We’ll try to see you quickly, within a week if you have a brain tumor or ten days for other conditions. During our consultation, we’ll explain your imaging scans, laying out all your treatment options, their risks and benefits. 

The complexity of the anatomy under your brain makes skull base surgery a multidisciplinary process. We work collaboratively with board-certified and fellowship-trained experts in:

• neurosurgery 
• neuro-otology 
• head and neck surgery 
• otolaryngology (ear, nose and throat) 
• ophthalmology 
• pathology
• oncology
• neuroradiology 
• plastic surgery and
• physical therapy

We treat the most difficult cases in the region.

How to work with us

If you suddenly experience new headache or seizure symptoms, you may find yourself visiting the emergency room, your primary care doctor or neurologist. You’ll have a brain scan, and if there’s a tumor or other issue in your skull base, they can refer you to us. Or you can call and make an appointment. 

We’re happy to serve our local community here in Orange County. We also get referrals from the Inland Empire, San Diego, Los Angeles and other states.

What is skull base surgery?

Skull base surgeons remove tumors and cysts or repair abnormalities in the complex area beneath the brain. It is related to brain surgery. The procedure is a collaboration between expert surgeons, head and neck specialists and ear, nose and throat doctors.

Your cranial nerves, major blood vessels and spinal cord are tightly packed into this delicate area. That is why this surgery requires tremendous precision. 

What type of conditions would require surgery of the skull base?

• benign tumors
• malignant tumors
• various types of cysts
• abnormal bone growths
• other structural abnormalities

How is skull base surgery performed?

We use two methods to perform skull base surgery, minimal or maximally invasive techniques. The least invasive method involves performing surgery through your nose or mouth with no incisions. 

In some cases, we make a small incision just above the eyebrow to remove tumors. Or your surgeon might drill a tiny hole through the skull. This allows them to insert a small tube deep into the brain to remove a tumor otherwise hard to access.

Traditional open surgery, also known as a craniotomy, is the other option. The location of your tumor helps determine which type of surgery is best. We use minimally invasive techniques whenever possible.

How long does skull base surgery take?

Skull base surgery can take from two to six hours depending on the tumor’s location or complexity.

Benefits of skull base surgery

The benefits of skull base surgery include:

• removing a benign or malignant tumor in an area previously considered inoperable
• successfully repairing abnormalities
• reduced pain and discomfort
• less time in hospital
• faster recovery
• avoid traditional risks like: infection bleeding stroke and more
• no facial scarring

Our UCI Health skull base surgeons are especially skilled in the latest endoscopic and microsurgical techniques. We will tailor treatments to you to make sure you receive appropriate, evidence-based care.

Your tumor’s location will determine whether or not minimally invasive surgery is an option. Our experts also perform craniotomies to remove tumors and repair abnormalities.

What to expect

During your consultation, you can expect your surgeon to discuss your diagnostic test results and more. We work with you holistically, taking your physical, psychological and emotional needs into account. 

Your doctor will tell you about the general risks involved in your surgery and the specific risks for your condition. 

Our expert team performs about 1,800 to 2,000 skull base surgeries a year. Remember, you can ask us anything or share any concerns. We’re here to do our best.

Your pre-op appointment

During your pre-op appointment, we give you a special cleanser to wash your body with before the surgery. You’ll learn guidelines about what medicines you need to stop taking, and which ones to keep taking. We’ll let you know when not to eat and what time to come in.

An overview of the procedure

Once you’re situated, ear, nose and throat doctors with special skull base surgery training insert an endoscope into your nostril. This long thin tube has a camera at the end. We use live imaging during the procedure for pinpoint accuracy. 

The neurosurgeon will then come in to remove the tumor using an intricate set of tools. 

What happens after my skull base surgery?

You may or may not need chemotherapy, radiation or immunotherapy after brain surgery. But once your procedure is done, a neuro-critical care team will monitor you in the ICU. We’ve established a pet therapy program so you can have a beloved pet by your side to speed your recovery.

Expect to stay at UCI Health for one to three days. If you need extra help or live alone, we may recommend you then recover at a skilled nursing facility. Recovery generally takes from four to six weeks. 

We’ll have you come back ten to 14 days after surgery to meet with your teams. That could include endocrinologists, neuro-oncologists, and radiation oncologists. We will follow up again one month or three months later. 

Long-term follow-up

Your long-term care is critical to the healing process. We’ll monitor how you’re doing and manage any post-operative pain or seizures. One of our clinicians is always on call 24/7 if you need to reach us.

Why choose UCI Health for skull base surgery?

Minimally invasive skull base surgery has changed the game

Our doctors remove tumors and fix abnormalities in areas that used to be unreachable. The precision that’s now possible with endoscopic techniques is remarkable. Our skull base surgeons are specially trained in the most advanced techniques. 

Minimally invasive operations mean faster recovery, less trauma to the body, less discomfort and fewer side effects.

One of our biggest strengths is our multidisciplinary team approach

Who your team members are depends on your diagnosis and needs. Because of our large infrastructure, we’re never acting alone. We can quickly assemble the right team to handle radiation or chemo, to check your hormone balance or manage pain. 

Our tumor board meets weekly to tackle the most difficult cases

As a group, we discuss every challenging case that comes our way. It helps us arrive at a consensus about the best way to treat a demanding illness or high-risk patient. Getting second opinions from each other and our mentors ensures that we do the right thing.

Our whole team operates on about 1,800 to 2,000 skull base cases a year

There’s no substitute for hands-on, clinical experience. We work with an exceptionally high volume of patients. This produces a marked increase in quality compared to centers that work with fewer cases. Ask us anything.