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The Skull Base Surgery Program at UNC School of Medicine is a state-of-the-art, multidisciplinary center that delivers cutting-edge care for complex cranial base pathologies. The program excels in managing anterior cranial base conditions, endoscopic skull base surgeries, lateral skull base procedures, and acoustic neuroma surgeries. Through close collaboration with specialists in neuro-oncology, radiation therapy, and radiosurgery, the team provides comprehensive, personalized treatment plans. This advanced program integrates expertise across disciplines to ensure optimal outcomes for patients with challenging skull base tumors and disorders.

Endonasal approaches, UNC Health Department of Neurosurgery. Image by Xian Boles, MFA
Endonasal surgical approaches. Illustration by Xian Boles, MFA

Skull Base Tumor Surgery at UNC Health

Our neurosurgeons are trained to treat all conditions and diseases of the skull base. UNC Neurosurgery works alongside UNC’s Department of Otolaryngology to perform minimally invasive procedures for more effective treatment and removal of skull base tumors and lesions. Minimally invasive procedures generally result in shorter hospital stays, a more rapid recovery, and less overall complications compared to traditional open approaches.

UNC Neurosurgery’s partnership with UNC’s Otolaryngology Department has advanced clinical paradigms and academic endeavors that are centered on the treatment of skull base tumors. This includes pituitary tumor treatment in our multidisciplinary pituitary tumor clinic. The skull base surgical team performs approximately 3-4 invasive pituitary tumor surgeries a week.

Our skull base tumor experts have a combined 100 years of experience in skull base surgery. Each of our neurosurgeons on the skull base team is highly specialized in skull base surgery, having completed skull base surgery fellowships, and they continue to lead in both lateral skull base surgery and anterior skull base surgery. Both groups of surgeons use advanced surgical techniques and cutting edge technology. Our neurosurgeons are often selected as keynote speakers at neurosurgery events such as the annual North American Skull Base Society Conference.

UNC Skull Base Center

At the UNC Skull Base Center, our expert skull base surgical team includes neurosurgeons, ENT surgeons, radiation oncologists, medical oncologists, ophthalmologists, and endocrinologists. This team approach allows us to produce high-quality results and better patient outcomes with the least invasive surgical methods possible. Each of the physicians involved lend their recommendation from their respective field and then collaborate with the other physicians at the Skull Base Center to design the right treatment plan for each patient. This system keeps the patient at the center of care and ensures that the patient is receiving an unbiased opinion on their skull base tumor or lesion treatment.

What is skull base surgery?

During surgery, our skull base surgical team removes skull base tumors through natural openings of the body, such as the nose, using minimally invasive procedures when possible. Our neurosurgeons and ENT surgeons specialize in different skull base approaches and have logged over 100 hours performing these procedures. They work together to remove skull base tumors through the right minimally invasive approach without causing structural damage.

UNC is a leader in the treatment of acoustic neuromas and vestibular schwannomas. Tumors and lesions in this area are difficult to access with minimal affect on hearing, but the Skull Base Team has continued to collect and evaluate patient outcomes using all three main surgical access routes. The surgical access route for each case is determined by the size and location of the skull base tumor or lesion.

UNC is a world leader in expanded endonasal skull base surgery and we are one of only a few skull base surgery treatment centers in the nation. Our neurosurgeons have developed novel techniques of reconstruction of the skull base. The members of the lateral skull base surgery team are acoustic neuroma experts.

The UNC Skull Base Center is one of only a few in the country that offers expertise in both endoscopic and traditional transfacial or transcranial skull base surgery. In addition to our Skull Base Center, UNC also hosts a Skull Base Course in our state-of-the-art skills lab to train other surgeons on lateral skull base surgery and anterior skull base techniques.

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