Led by ENT/Head and Neck Surgery Chairman Eric M. Genden, MD, and Neurosurgery Chairman Joshua B. Bederson, MD, the Skull Base Surgery Center at Mount Sinai is one of the few multidisciplinary centers throughout the world dedicated to the evaluation and treatment of benign and malignant tumors of the skull base (floor of the cranium). These tumors can arise in various sites at the base of the eye socket, behind the nasal cavity, surrounding the inner ear, or within the cheekbones.

Mount Sinai has a long established history as a leader in the minimally invasive treatment of the full range of skull base tumors and lesions. Our team pioneered surgical techniques in the reconstruction of the arteries at the base of the brain and in microvascular free tissue transfer. We continue this tradition of leadership and excellence through the use of transoral robotic surgery (TORS), 3-D navigation planning, intraoperative neurophysiological monitoring (IONM), surgical simulation, and cutting edge research in order to provide patients with the safest and highest quality of care possible.

Our Multidisciplinary Skull Base Team

Due to the highly complex and delicate anatomy of the cranial base, these tumors are some of the most technically challenging tumors to treat. To ensure that our patients receive the most comprehensive care, we have assembled a multidisciplinary team of neurosurgeons, head and neck surgeons, neurotologists, microvascular reconstructive surgeons, otologists and neuro-otologists, radiation oncologists, pathologists, and medical oncologists, who collaborate together with the shared goal of determining and implementing the optimal treatment path for each patient.

Treatment of Skull Base Tumors

Depending on the type of tumor and the specific location there are many different surgical approaches that can be implemented. After proper diagnosis, which in most cases is done by a surgical biopsy, all of our patients are discussed during a multidisciplinary tumor board, comprised of surgical oncologists, medical oncologists, radiation oncologists, radiologists and pathologists.

Surgical treatment includes both open (external-skin incisions) and minimally invasive (without incisions) techniques, depending on the type and location of the tumor. Our surgeons at the Skull Base Surgery Center are fellowship-trained in both open and minimally invasive/endoscopic skull base surgery.

In the past decade there have been significant advances in technology to allow surgeons to perform procedures at the skull base without the need for incisions on the face or head. These surgeons have been specially trained to use high-definition telescopes, intraoperative neuronavigation and specialized instruments to safely perform surgery at the skull base.

The advantage of the minimally invasive approach include:

• No visible scars or incision
• Improved cosmetic appearance
• Less blood loss
• Shorter hospital stay (some patients go home the same day)
• Quicker recovery and return to normal activities
• Less post-operative discomfort
• Decreased complications
• Cost efficiency (reduction of OR time, necessary staff, utility of materials, and length of hospital stay – all of which translate to cost savings to the hospital and ultimately each patient)

Our recommended personalized treatment plans include the approach that can provide patients with the highest chance for cure and maximum quality of life.

Skull Base Surgery Center Follow-up Care at Mount Sinai

All skull base surgery patients are scheduled for several follow-up appointments that include a post-operative checkup and surveillance. In addition, we provide various support services, such as rehabilitation and speech therapy. We ensure that each patient also has proper follow-up with the neurosurgery team and medical oncologists. Our goal is to provide seamless multidisciplinary care to monitor our patients’ progress and prevent their cancer from returning.