Only within the past few years have patients with tumors or lesions of the skull base had the opportunity of having these problems treated surgically. Massive tumors once thought to be unresectable are now approachable. Formerly destructive and morbid surgery was the only was to access the skull base. With the advent of endoscopic or minimally invasive techniques, the sequelae from cranial base surgery have been reduced dramatically. With advances in diagnostic imaging tools, anesthesia breakthroughs, refined and innovative surgical techniques, and stereotactic tumor localization, these patients today have hope where once there was only the dark prospect of lingering illness and death.
The Beverly Hills Skull Base Center was created by pre-eminent area academicians to fill the void in skull base patient care seen in the United States especially on the west coast. They sought out and assembled a team unsurpassed in the country. The Center now draws patients from all over the United States and beyond. The SBC uses a multi-disciplinary approach to evaluate, treat and care for patients who have skull base lesions. Complex patients have the advantage of being presented to a top-flight tumor board that develops a detailed plan for the care of the patient. The goal of the Center is to combine nationally-respected and board-certified surgeons and highly skilled health professionals to maximize the treatment of patients with skull base disease. The specialties include neurosurgery, neouroopthomology neourootology, head and neck surgery, otolaryngology, advanced facial reconstructionists, electrophysiology, radiation and medical oncology, speech and swallowing therapy, neuromuscular and facial nerve rehabilitation, interventional neuroradiology, neuroendoscopists, audiology, electrophysiology and neuropsychology. The latest diagnostic tools and techniques are employed including computerized tomography (CT-including 3-D reconstructions, spiral and fine slices), magnetic resonance imaging (MRI) and angiography (MRA), xenon cerebral flow measurement, PET scanning, advanced vestibular testing, and SPECT scanning.
Neuroendoscopy is an exciting advancement in the quest to provide our patients with safer techniques. Although "drive-thru" brain surgery is an exaggeration, it may not be as futuristic as we once believed. Brain surgery has many different connotations to the general public, but very few would see it as minimally invasive as one-day surgery. Historically, patients undergoing brain surgery would inevitably be faced with neurological deficits, sometimes even resulting in a vegetative state. Hollywood reinforced this misconception by depicting the neurosurgical patient with his head shaved, wrapped in an extensive dressing, often in a coma for days only to make a miraculous, but unfortunate and incomplete recovery. With the trend towards minimally invasive surgery for patient and cost benefits, endoscopic surgery has gained immense popularity over the last few decades in most of the surgical subspecialties. Neurosurgeons have been slow to adopt the discipline largely due to limited technology and the inherent difference between the brain and other organs of the body. However, with advances in technology we can now offer our patients safe and effective minimally invasive endoscopic brain surgery. In the figure below, the small brow incision is much better than the shaved scalp and incision all the way across the head.
Some symptoms to be aware of:: facial pain, neck pain, loss of vision (especially in one eye), loss of smell, lack of movement in the face, hoarseness, facial spasms, balance problems, hearing loss (especially in one side), thickening bones, spontaneous milk from breasts, trouble swallowing, unexplained headaches, watery fluid from nose or ear, chronic ear pain, and seizures.
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