Department of Otolaryngology > Clinical Specialties > ear-surgery > Minimally Invasive Endoscopic Skull Base Surgery

Minimally Invasive Endoscopic Skull Base Surgery

Minimally Invasive Endoscopic Skull Base Surgery at
University of California Irvine Medical Center

The Endoscopic Approach to the anterior skull base is an innovative technique used for brain tumor removal through the nose by traversing sinuses. This type of procedure requires a multidisciplinary team of neurosurgeons and otolaryngologists.

Endoscope provides the light and visualization necessary for viewing the internal images. Specialized instruments are used through the nose for tumor removal. In the past, these procedures were performed with large incisions and required long hospitalizations with multiple complications. With the endoscopic approach, the procedures can be performed in a minimally invasive fashion, with a shorter hospitalization, and without visible scars on the face or scalp.

Using the minimally invasive surgical approach uses the nose and sinuses as channels to reach tumors and lesions in difficult to reach and areas at the skull base. The Endoscopic Skull Base Approach allows our expert surgeons to treat many hard-to-reach tumors, even those once considered "inoperable," without disturbing the face or skull.

UC Irvine surgeons have extensive experience with the endoscopic approach to the skull base. In addition to its success in adults, endoscopic skull base surgery has been performed in children for various tumors or lesions.

Procedures that are amenable to treatment with a minimally invasive skull base approach include:

Acromegaly

Adenocarcinoma

Adenoid Cystic Carcinoma

Adenoma

Angiofibroma

Arachnoid Cyst

Basilar Invagination

Brain Metastases

Brain Tumors

Cerebral (Brain) Aneurysm

Cerebrospinal Fluid (CSF) Leak

Chiari Malformation

Cholesterol Granuloma

Chondroma

Chondrosarcoma

Chordoma

Craniofacial Fracture

Craniofacial Malformation

Craniopharyngioma

Cushing's Disease

Dermoid & Epidermoid Tumors

Encephalocele

Esthesioneuroblastoma

Fibrous Dysplasia

Glomus Tumor

Hemangiopericytoma

Invasive Fungal Sinusitis

Inverted Papilloma

Meningioma

Meningocele

Neurofibroma

Olfactory Neuroblastoma

Optic Nerve Compression

Orbital Inflammatory Pseudotumor

Osteoma

Osteosarcoma

Pituitary Adenoma

Pituitary Apoplexy

Pituitary Tumor

Pseudotumor Cerebri

Rathke Cleft Cyst

Rhabdomyosarcoma

Rheumatoid Pannus

Sinus Tumor

Squamous Cell Carcinoma

Advantages of the Endoscopic Approach compared to the traditional approaches:

Elimination of the cosmetic problems
No incisions on the face, nose, scalp, or under the lip
Minimal pain or discomfort post-operatively
Significantly shorter procedure duration
No need for a large retractor placed in the nose
Reduced likelihood of scarring in nose
No radiation intra-operatively
The ability to place an angled endoscope within the tumor cavity and to see areas behind ledges not always possible with the traditional approaches with a microscope

The endoscopic skull base surgeon works with the neurosurgeons at the UCI Medical Center in the removal of pituitary tumors using the endoscopic approach. The minimally invasive approach and resection is done with the two surgeons working side by side.

New Innovations in the Treatment of Skull Base Tumors

The Team Approach to the treatment of skull base tumors has become the best approach in the treatment of these complex disorders. The team involves a head and neck skull base surgeon (neurotologist or anterior skull base surgeon) and a skull base neurosurgeon. The combination of the two specialties allows for the best care for the patients. The Skull Base Surgery Team at UC Irvine discusses the plan of treatment for the patients and plans for the best option for each particular patient. The team also reviews imaging studies for patients from outside of Southern California before their visit and accommodates these patients to give them the best possible and most efficient care.

Computer-assisted Navigation

Computer-assisted imaging navigation has allowed for better identification and preservation of sensitive structures during surgery of skull base tumors. Using this technology, the surgeons can visualize on the screen in 3 dimensions where a particular tumor and its surrounding structures are located while performing the surgery to reduce the chance of complications. Computer-assisted image guidance navigation is a routine part of the skull base team's.

Intra-operative MRI

Another area of cutting edge technology available at the UC Irvine Skull Base Program is the use of imaging during the surgery to insure that the entire tumor has been removed. The special intra-operative MRI suite allows the skull base surgeons to obtain an MRI during the surgery to see if the entire tumor has been removed.

Minimally Invasive Endoscopic Skull Base Surgery