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Skull Base Surgical Treatment Options

Minimally Invasive Endoscopic Surgical Techniques

Endonasal SurgeryMany skull base disorders, especially pituitary tumors, can be surgically treated or removed through the sinus cavity, an endonasal technique. This minimally invasive technique is performed jointly between neurosurgeons and ear, nose, and throat (ENT) surgeons, and requires access through the nose, or from behind the ear. Surgeons at the Penn Center for Cranial Base Surgery use state-of-the-art navigation, optics and surgical techniques to remove skull base tumors through small incisions. These advanced techniques — many pioneered here at Penn — reduce the need for brain manipulation or resecting normal structures. The result is improved outcomes and patient safety, as well as dramatically reducing the cosmetic impact of surgery.

Advanced Microscopic, Laser and Ultrasonic Techniques

Penn performs advanced microscopic, laser and ultrasound techniques on certain types of tumors that are buried deep within the base of the skull. The laser, for example, allows surgeons to remove these tumors in less time, decreasing risk of complications, less use of anesthesia and a reduced possibility of damage to surrounding healthy brain and nerve tissue.

Restorative and Reconstructive Facial and Skull Base Surgery

The Center for Cranial Base Surgery has a team of surgeons dedicated to restoring the functional and cosmetic elements of a patient’s health. Restorative techniques such as microvascular reconstruction, nerve and muscle grafting, facial reanimation and soft tissue restoration are implemented as an important part of a patient’s treatment and overall outcome.

Open Skull Surgery

Surgeons perform open skull surgery when necessary. This procedure may require incisions in the facial area and in the skull. Surgeons may need to remove parts of bones so that the tumor can be reached and removed. Advanced imaging is often used for this type of surgery.

Watchful Waiting

Some skull base disorders including tumors don’t require surgery and are monitored for some time to see if they grow.

Clinical Trials

Penn Medicine is a leader in research and conducts many clinical trials to discover new drugs, new surgical techniques and new devices. Clinical trials are also conducted to test cutting-edge and novel therapies. Not everyone with a disease or problem can take part in a research study. If your doctor thinks that you might qualify for a study, he or she may present it as a treatment option. Likewise, if you are interested in knowing if you qualify for a trial, please ask your healthcare provider for more information.


Radiosurgery uses beams of ionizing radiation to precisely target a tumor so that surrounding structures receive little radiation. It can serve as stand-alone therapy or in addition to a surgical resection. Many tumors, especially those that are difficult to access surgically, are treated with these techniques.

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