The surgical team at the MedStar Georgetown University Hospital Skull Base Center offer nationally-renowned expertise in minimally invasive, endoscopic techniques.
While rare, many types of tumors can develop in the “skull base,” or the gap between the bottom of the brain and the part of the skull that is directly below it. Depending on the size and location of the tumor, diseased tissue can often be removed endoscopically. This type of surgery is also sometimes called “neuroendoscopy,” “expanded endonasal approaches,” or “minimally invasive brain surgery.”
Endoscopic surgery is minimally invasive and typically does not require any incisions. This approach can be used to avoid traditional approaches that require an open craniotomy. Compared to traditional approaches, minimally invasive techniques allow for less pain and scarring, faster recovery, and lowered risk of complications.
During endoscopic skull base surgery, a thin, camera called an endoscope is inserted into a natural opening in the body, such as the nose (an approach that is called “endonasal”). The endoscope is used in conjunction with specially designed long and narrow surgical tools. The surgical team uses a video monitor to guide their work.
Cutting-edge technology helps our expert surgical team to achieve optimal patient outcomes. Neuronavigational guiding technology provides a high-tech “GPS”, guiding the surgeon’s movement within the brain. Neurophysiological monitoring technology tracks electrical activity within the patient’s brain throughout a surgical procedure, ensuring that the brain is continuing to function appropriately.
Specific types of minimally invasive endoscopic surgeries include:
- Endoscopic endonasal resection of pituitary tumors: This technique allows surgeons to remove diseased tissue in the pituitary gland, operating via an endoscope that is inserted through the nose.
- Expanded endoscopic endonasal resection of skull base tumors: This technique allows surgeons to remove diseased tissue found in the area between the brain and sinuses, operating via an endoscope that is inserted through the nose.
- Endoscopic endonasal treatments for cerebrospinal fluid (CSF) leaks and encephalocele: CSF is a clear liquid that surrounds the brain and spinal cord. When this fluid leaks, surgery is typically required. This technique allows surgeons to operate via an endoscope that is inserted through the nose.
- Endoscopic endonasal treatment of the upper spine and clivus: The upper cervical spine is another term for the neck. The clivus is a particular bone found in the skull base. Problems affecting these areas can include chordomas, odontoid fractures, basilar invagination, and rheumatoid pannus. This technique allows surgeons to operate on this area of the skull base via an endoscope that inserted through the nose.
- Endoscopic endonasal treatment for brain tumors: A brain tumor is a benign (non-cancerous) or malignant (cancerous) growth that develops in the brain. This term is also sometimes used to describe tumors that did not originally begin their growth in the brain, but have expanded there from another part of the body. This surgical approach allows clinicians to remove diseased tissue from in and around the brain, operating via an endoscope that is inserted through the nose.
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