Clinical Services

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  • Skull Base Surgery

    Skull Base Surgery refers to those surgical techniques that allow access to lesions in and around the skull base. In many cases, such lesions can not be safely or effectively approached using conventional techniques. The UMMC Skull Base Surgery Program is one of only a few specialized programs in the world offering comprehensive skull base surgical capability for children and adults.

    Drawing on the diverse experience of the faculty of the Department of Neurosurgery, lesions arising anywhere between the craniocervical junction and the craniofacial junction are managed by a multidisciplinary team including Otolaryngology, Plastic and Reconstructive Surgery, Ophthalmology, Neuroradiology, Anesthesiology, Radiation Oncology, Pathology, and Physical Medicine and Rehabilitation.

    Lesions that may be considered for skull base surgery include:


    • Meningiomas
    • Pituitary tumors
    • Schwannomas
    • Neurofibromas
    • Craniopharyngiomas
    • Esthesioneuroblastomas
    • Chordomas, chondromas, chondrosarcomas
    • Paranasal sinus tumors
    • Pharyngeal tumors
    • Temporal bone tumors
    • Dermoids, epidermoids
    • Glomus tumors
    • Orbital tumors
    • Giant cell bone tumors
    • Angiofibromas
    • Melanomas
    • Fibrous dysplasia

    Vascular lesions

    • Aneurysms (anterior communicating, paraclinoidal, cavernous sinus, posterior circulation)
    • Arteriovenous malformations (AVMs)
    • Cavernous angiomas
    • Dural AVMs

    Congenital lesions

    • Craniofacial malformations
    • Cystic lesions
    • Encephaloceles (frontoethmoidal and sphenoidal)
    • Basilar invagination

    Traumatic lesions

    • Skull base fractures including orbital apex
    • Craniofacial fractures
    • Cerebrospinal fluid fistulas

    Presurgical considerations

    Preoperative evaluation includes a complete medical history, general physical and neurological examinations, otolaryngological and ophthalmological evaluations, and comprehensive radiological studies. Specific skull base surgical options are considered as well as postoperative rehabilitation and adjunctive treatment modalities. All recommendations are then discussed with the patient, family, and referring physician. The patient and family have the opportunity to speak with other patients who have had a similar experience through the Skull Base Surgery Support Group.

    State-of-the-art technology

    In addition to high-resolution computed tomography, magnetic resonance imaging, and conventional multi-planar angiography, MR angiography, MR spectroscopy, and interventional neuroradiological procedures including transarterial embolization (to decrease tumor vascularity) and carotid balloon test occlusion are available. Frameless stereotactic surgical navigation, intraoperative angiography and microDoppler, the surgical laser and ultrasonic aspirator, intraoperative electrophysiologic monitoring, stereotactic radiosurgery, spinal instrumentation, and interventional MRI are routinely available.


    A skull base dissection laboratory is utilized for resident teaching.


    • Andrew D. Parent, MDView profile 
      • Craniofacial disorders
      • Pituitary disorders
    • Haynes L. Harkey III, MDView profile
      • Craniovertebral junction disorders