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Less-invasive brain surgery
When an aneurysm or tumor sits below the brain, skull base surgery can remove the lesion in a less invasive way than open brain surgery.
Your brain sits on the skull base or bottom part of the skull. This area includes your eye sockets, cheek bone, the top of your palate, your ear canals and the bottom part of your skull at the back of your head.
With skull base surgery, your neurosurgeon reaches the aneurysm or tumor from underneath the brain. Delicate surgical tools access the tumor through your nose and nasal passageways. This technique means you recover faster and have less risk for complications than with traditional open skull surgery.
What is skull base surgery?
We use the minimally invasive endoscopic endonasal approach for skull base surgery. This method avoids potential damage to your brain. Your neurosurgeon uses a long, thin, flexible telescope called an endoscope. They thread the endoscope through your nasal passageways to reach the tumor beneath your brain.
What conditions does this surgery treat?
We use skull base surgery to treat certain types of aneurysms and brain and pituitary tumors.
We take MRI and CT scans to diagnose and locate your tumor. Your doctor decides if skull base surgery is right for you based on your tumor location.
We use skull base surgery to care for patients with:
Encephalocele (cerebral spinal fluid leak)
Epidermoid (congenital cholesteatoma)
Glomus jugulare tumors
Facial nerve disorders
Jugular foramen tumors
Petrous apex tumors
Skull base infections and osteomyelitis
Temporal bone auditory canal carcinoma
Tic douloureux (trigeminal neuralgia)
Will skull base surgery work for you?
Before surgery, a nurse practitioner, neurosurgeon and an otolaryngologist (if needed), evaluate your health and your tumor to ensure that the procedure is the best option for you.
You meet with your tumor team to discuss what happens during skull base surgery. You also talk about the risks and benefits of the procedure.
You might need additional testing, including:
Cerebral angiogram: This test determines the relationship of the arteries to the tumor. Your doctor uses it when a tumor is close to blood vessels.
Stealth MRI: Your neurosurgeon uses this type of navigational MRI in the operating room to plan for the surgery.
What to expect during skull base surgery
On the day of your surgery, you meet with your tumor team to answer your questions. You receive anesthesia to put you to sleep so you do not feel pain during the procedure.
Using the endoscopic endonasal approach, your surgeon:
Carefully inserts an endoscope through your nose and nasal cavities
Removes a small area at the base of your skull to access the tumor
Uses tools attached to the endoscope to take out the tumor or lesion
Closes the hole in the base of your skull
Removes the endoscope
The endoscopic endonasal procedure can take two to six hours depending on your type of tumor and its location. After surgery, your doctor fills your nose with nasal packing.
You spend two or more days in the hospital before returning home.
Your recovery time can range from three to four days to several weeks, depending on the exact surgical approach and the tumor location.
Meet our team
Experts in complex neurosurgical care
The neurosurgery team at UW Health includes experts in skull base surgery.
Skull base surgery locations
We offer specialized skull base surgery at our neurosurgery clinics in Madison, Wis.