Multidisciplinary treatment for skull base disease

The Skull Base Center at Baylor University Medical Center, part of Baylor Scott & White Health, is one of the few places in Texas that offers comprehensive treatment for the large variety of often complex conditions and tumors in and around the various compartments of the skull base.

Priorities of the Skull Base Center:

  • Cure or control of the disease
  • Minimally invasive treatment
  • Preservation of function
  • Quality of life

A commitment to minimally invasive skull base surgery has allowed the creation of surgical techniques that help achieve the goals of preserving function and maximizing the quality of life for patients.

Skull base conditions

  • Acoustic neurinoma/schwannoma
  • Brainstem tumors
  • Cerebellopontine angle tumors
  • Chondrosarcoma
  • Chordoma
  • Craniopharyngioma
  • Dermoid and epidermoid tumors
  • Facial nerve neurinoma/Schwannoma
  • Fibrous dysplasia
  • Glomus jugulare tumor
  • Lower cranial nerve tumors
  • Pineal tumors
  • Pituitary tumors
  • Trigeminal nerve neurinoma/Schwannoma

Vascular cerebral aneurysm

  • Arterial venous malformation (AVM)
  • Cavernous malformation

Occipital cervical junction

  • Basilar invagination
  • C1-C2 subluxation (rheumatoid arthritis)
  • Chiari malformation
  • Foramen magnum tumors

Orbital Lesions

  • Exophthalmos
  • Fibrous dysplasia
  • Hemangioblastoma
  • Meningioma
  • Schwannoma

Head and neck

Temporal bone

Causes of skull base conditions

Lesions and tumors in the skull base can be located in several areas:

  • Extracranial
  • Intracranial
  • Orbital

Types of lesions located in the skull base may include:

  • Benign or malignant tumors
  • Congenital disorders (chiari malformation, basilar invagination)
  • Pain syndromes (trigeminal neuralgia)
  • Rheumatological disorders (rheumatoid arthritis C1-C2 subluxation)
  • Vascular processes (aneurysm, arterial venous malformation, cavernous malformation)

Skull base disease treatment options

Treatment recommendations are made after careful analysis of radiological data; location and type of lesion; and evaluation of each patient’s unique health profile, needs and expectation. The treatment may include one or more of the following modalities:

  • Interventional neuroradiology

    In selected cases, the interventional neuroradiology team at Baylor University Medical Center provides angiographic preoperative evaluation of the feeding vessels to lesions, allowing more accurate surgical planning.

    In some cases, tumors with high vascularity are embolized preoperatively, allowing safer surgical resection of the tumor and less blood loss.

    Patients with cerebral aneurysms are evaluated by a neurosurgeon and an interventional neuroradiologist to determine the most effective treatment modality for each patient.

    Treatment for cerebral aneurysms includes intravascular packing and obliteration of the aneurysm with flexible coil or craniotomy and clipping of the aneurysm.

    At the Skull Base Center preference is given, whenever possible, to intravascular treatment of cerebral aneurysms, avoiding craniotomy and brain manipulation.

  • Skull base surgery

    When surgery is necessary, preference is given to the use of minimally invasive techniques, including:

    • Bi-directional approach
    • Endoscopic-assisted microneurosurgery
    • Facial degloving
    • Focused skull base approaches
    • Head and neck approaches
    • Reconstruction
    • Transfacial and bidirectional approaches
    • Transnasal endoscopic approach

Comprehensive services through the Skull Base Center

Numerous departments and services at Baylor University Medical Center support the Skull Base Center, allowing comprehensive evaluation and care in the diagnosis and treatment of skull base disease:

Skull base services

  • Endocrinology
  • Head and neck oncology
  • Medical oncology
  • Neurological rehabilitation (physiatry)
  • Neurology
  • Neuroradiology
  • Neurosurgery
  • Otolaryngology (head and neck surgery)
  • Pathology
  • Radiation oncology
  • Speech (swallowing therapy)

Skull base programs

  • Acoustic neurinoma program
  • Chiari malformation program
  • Chordoma/Chondrosarcoma program
  • CSF leak program
  • Endonasal endoscopic surgery program
  • Exophthalmos program
  • Glomus/Paraganglioma program
  • Head and neck tumor program
  • Meningioma program
  • Occipital cervical program (rheumatoid arthritis)
  • Orbital tumor program
  • Pituitary tumor program
  • Trigeminal neuralgia program

Medical leadership

Amol Bhatki, MD

Co-Medical Director
Baylor Neuroscience Center's Skull Base Center

Caetano Coimbra, MD

Co-Medical Director
Baylor Neuroscience Center's Skull Base Center