Skull Base and Complex Tumors
Physicians: Dr. Robert Rostomily and Dr. Laligam Sekhar
Tumors at the cranial base, or skull base tumors, require specialized operative techniques for approach, removal, and repair. These include:
Radiosurgery may be used in conjunction with microsurgery. Experience and expertise play a major role in positive patient outcome.
Case Studies
Case #1
This 50-year old woman had a giant olfactory groove-planum meningioma and underwent a complete resection (surgical removal) of the tumor.
Case #2
A 50-year old man with a giant left acoustic neuroma, (a benign tissue growth on the eighth cranial nerve that leads from the brain to the inner ear), underwent a complete surgical removal (resection) of his tumor by microsurgical techniques. The procedure preserved the patient’s hearing as well as normal facial function on that side.
Case #3
A 40-year old man with a 2cm right acoustic neuroma. Pre-op audiogram and post-op audiogram show hearing preservation after microsurgery.
Case #4
A 38-year old woman with a large petroclival meningioma with no brainstem edema (swelling due to a buildup of fluid). The PLPA approach (Partial Labyrinthectomy Petrous Apicectomy) was used to expose the tumor. The tumor was surgically removed, and the post-operative MRI showed no residual tumor. A post-operative audiogram demonstrated preservation of hearing on the left side.
Case #5
This case involved a 60-year woman with a large left sphenoid and cavernous sinus meningioma with vessel encasement and narrowing. Surgery was complex, and involved the dissection of artery and nerves, freeing them of the tumor. The post-op MRI shows no residual tumor. The patient returned to a normal life after surgery.
Case #6
This case involved a 40-year old man with a giant olfactory groove meningioma with vascular encasement.
In the graphic (below) note the following: 
(A) Patient’s angiogram reveals blood supply to tumor from the middle meningeal artery & ACA. Embolization of the tumor was performed using endovascular techniques.
(B) MRI shows swelling of the tumor after embolization.
(C) Post-op MRI shows complete excision of the tumor. Patient returned to normal life after three months.