In the past, tumors situated at the base of the skull generally had a poor prognosis. With a better understanding of skull base anatomy and significant improvements in neurosurgical techniques, however, many skull base tumors now can be successfully treated with surgery. At Advanced Brain & Spine, board-certified neurosurgeon Dr. Itay Melamed provides surgical treatment options for patients diagnosed with skull base tumors. If you’re in the Denver area, call or book your appointment online at one of the practice’s convenient locations in Centennial or Wheat Ridge, Colorado.
Any tumor that grows at the base of the skull — a complex region where the brain rests — is called a skull base tumor. These tumors can be challenging to treat, as the skull base itself is an irregular bone surface, and most of your nerves and blood vessels make their way in and out of your skull through its base.
There are many different tumors that can attack the skull base. Common skull base tumors include:
Skull base tumors are also classified according to their location. Anterior skull base, middle skull base, and posterior fossa skull base tumors all require different access approaches for successful treatment.
Some skull base tumors can just be watched; because these tumors tend to be slow-growing, treating them can sometimes be riskier than simply leaving them alone. Other skull base tumors can be successfully treated with radiosurgery, which is a more precise form of radiation therapy.
Sometimes, however, the only viable treatment option for skull base tumors is to operate, either to decompress the surrounding brain tissues, or to remove the tumors completely. Because there are major blood vessels and important nerves in the region, the surgical treatment or removal of skull base tumors requires a set of skills and knowledge that is different than that required for regular brain tumors.
Skull base surgery is typically done as a part of a team. Dr. Melamed’s team at Advanced Brain & Spine includes several first-rate ENT surgeons, ophthalmologists, and radiation and oncology doctors. Without this team of experts, treatment of skull base tumors wouldn’t be possible.
The endoscopic endonasal approach (EEA) has been around for a long time, and is considered a tried-and-tested surgical approach for skull base tumors. Because the technique uses the natural corridors of your sinuses to access the affected region, it requires an intimate knowledge of the anatomy along the sinuses and skull base.
The use of the endoscope and other specialized instruments, along with advanced image guidance techniques, is what enables Dr. Melamed and his team to use the EEA to treat or remove many of the different tumors that affect the skull base.
EEA is uniquely suited for dealing with skull base tumors because the endoscope lights the treatment area and allows the surgical team to work around corners; it even helps them see the critical structures on the other side of a tumor.
One of the main advantages of this approach is that it helps the team access these tumors without disturbing any of the surrounding brain structures. It also allows them to remove tumors completely, to the point where the patient is actually cured; this degree of treatment isn’t possible with other surgical methods.