Advanced Surgical Care for Children with Conditions of the Skull Base

The skull base is the bony shelf located behind the eyes and nose. It separates the brain from the eyes, nasal cavities, ear canals and upper neck. Skull base tumors and lesions may develop near critical brain structures, major nerves and blood vessels. Surgeons need a great deal of skill and experience to remove these lesions while avoiding healthy structures nearby.

When a lesion is large or very deep in the skull base, surgeons may need to do an “open” surgery with multiple incisions. But not always. Whenever possible, our surgeons use minimally invasive techniques involving smaller incisions (or no incisions) and tiny surgical tools. Minimally invasive techniques result in less bleeding and pain, fewer scars (or no scars) and a faster recovery. Surgeons use them to remove skull base lesions and reconstruct nasal and skull base structures when needed.

Cincinnati Children’s offers the full complement of minimally invasive technologies and techniques, including:

• Endoscopic endonasal surgery (operating through the nose rather than through large incisions). For example, our neurosurgeons are among only a few in the country to remove dermoid cysts  with an endonasal approach.
• Microscopic and robot-assisted surgery
• Advanced visualization with tools such as three-dimensional brain mapping

Our pediatric neurosurgeons, plastic surgeons and otolaryngologists (ear, nose and throat specialists, or ENTs) plan complex skull base surgeries together. They work side-by-side in our dedicated “BrainSUITE,” an operating room equipped with highly specialized equipment that helps surgeons be more precise in locating and removing skull base tumors. Cincinnati Children’s is the first children’s hospital in the world to have this system.

Advanced Care for Children with Cancerous Skull Base Lesions

A small percentage of skull base lesions are cancerous. In some situations, the care team will recommend proton therapy as part of the treatment plan. Proton therapy uses pencil beam scanning technology to destroy cancer cells while minimizing damage to healthy organs and tissue. It is one of the most precise and advanced forms of radiation therapy available in the world today. The Proton Therapy Center at Cincinnati Children’s is one of only two such centers in the world owned by a children’s hospital.