Skull Base Tumors

Skull Base Tumors

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Skull base tumors are located near areas that control your senses -- hearing and balance, sight, smell, and more. Because of their location, the surgical removal and follow-up care of skull base tumors require the skill, expertise, and coordinated care that can only be found at a high-volume and comprehensive skull base center like ours. If you or your child has been diagnosed with a skull base tumor, Duke's skull base experts -- conveniently located in both Raleigh and Durham -- can help. We work as a team to ensure you receive the best possible skull base tumor treatment while preserving your function and appearance.

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Skull Base Tumor Type and Location Guide Your Treatment Plan

Skull Base Tumor Types
There are many different skull base tumors, and each requires a different treatment approach. Treatment can range from watchful waiting to medication, radiation, and surgery. Identifying the type and location of your tumor is the first step. Common skull base tumors include:

  • Lateral (side of the skull base) tumors: acoustic neuroma (vestibular schwannoma), meningioma, glomus tumors, and chondrosarcomas
  • Anterior (front of the skull base) tumors: pituitary tumors, sinus and nasal cavity tumors, chordomas, meningiomas
  • Nerve tumors: facial nerve tumors, neurofibromatosis (NF2)
  • Ear masses: cholesteatomas and dermoid tumors
  • Cancerous tumors that have spread to the skull base from elsewhere in the body

Comprehensive Testing
The skull base surgeons in our comprehensive testing facility may use MRI and MRA (magnetic resonance angiogram), PET, and CT scans to create images of your skull. A biopsy may be performed to look at a small sample of cells under a microscope. You may also have tests of your hearing and balance, facial nerve and muscle activity, and vision, depending on your symptoms.

Our Locations
Duke Health offers locations throughout the Triangle. Find one near you.

Skull Base Surgery

Our primary goal during skull base surgery is to remove your tumor safely with minimal loss of vision, smell, taste, facial function, hearing, and balance. In some cases, we use MRI in the operating room to confirm that we have completely removed the tumor during the procedure. This reduces the need for additional procedures. We are one of only a handful of medical centers equipped with this technology.

Minimally Invasive Endoscopic Skull Base Surgery

This is often recommended to treat skull base tumors. A small tube called an endoscope is placed through the nose to reach and remove anterior skull base tumors such as pituitary and sinus and nasal cavity tumors. The procedure does not require large surgical incisions. As a result, you recover faster and experience less pain, with no scarring. 

Traditional Skull Base Surgery

Traditional surgery may be recommended to remove large tumors or skull base tumors that can’t be reached using minimally invasive techniques. These procedures are performed through or behind the ear to remove acoustic neuromas, glomus tumors, and meningiomas. When appropriate, we use hearing preservation surgical approaches, including middle fossa approach and suboccipital (retrosigmoid) approach. When large tumors or significant hearing loss is present, we often use the translabyrinthine (translab) approach.

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Skull Base Radiation Therapy

Radiation is often the best treatment for hard-to-reach skull base tumors and may be used in conjunction with surgery. Several systems ensure accurate delivery of radiation to the tumor while minimizing damage to healthy tissue.

Customized Radiation Plan

Treatment depends on the size, shape, and location of your tumor. Radiation therapy may be delivered in a single treatment (stereotactic radiosurgery), three to five treatments, or daily treatments over several weeks (stereotactic radiotherapy).

3-D Scans

MRI and CT scans are used to construct a model of your skull and ensure precision when targeting radiation to the tumor. X-rays and CT scans ensure you are in the exact position during treatment.

Intensity-Modulated Radiotherapy

Computer-controlled devices deliver high doses of radiation more precisely to specific areas within an irregularly-shaped skull base tumor.

Your Skull Base Tumor Care Team

Many specialists are involved in the treatment of your skull base tumor, which is why it is so important to seek skull base tumor treatment at a large medical center like Duke. Our skull base specialists are constantly developing new techniques, testing new treatments, and applying the latest research to improve your care and outcome. The doctors meet regularly to review all of our patients’ imaging results and determine the best course of treatment for each individual.

Skull Base Surgeons
Our skull base surgeons have had advanced training in the form of fellowships to become recognized experts in minimally invasive skull base surgery, rhinology (nasal and sinus problems), otology (ear-related disorders), and neurotology, which focuses specifically on neurological disorders of the ear. Because the tumor is based in the head and neck area, your team often includes otolaryngologists (ear nose and throat surgeons) and neurosurgeons (brain surgeons) who work hand-in-hand during these complex surgical procedures.

Plastic Surgeons
If you or your child requires reconstructive surgery, a plastic reconstructive surgeon dedicated to the head and neck may be part of your team.

Radiation Oncologists
Radiation treatment may be recommended alone or in combination with surgery. Your radiation oncologist will lead a team of radiation therapists, medical physicists, dosimetrists, and nurses, who work together to optimize your experience and outcome.

Need a Second Opinion?

Our skull base tumor experts will review your diagnostic scans performed elsewhere and contact you to discuss an effective treatment plan.​ Please call 919-681-9928, and our nurse navigator will help make arrangements for your second opinion.

Why Choose Duke

A Broad Range of Medical Experts
Our team includes other subspecialists who are ready to address your needs, such as experts in balance, hearing, voice, and swallowing.

Dedicated Nurse Navigator
Your dedicated nurse navigator will help coordinate your appointments and surgery, discuss test results, and be there for you every step of the way.

Follow-Up Care Near Your Home
If you choose to undergo surgery to treat your skull base tumor at Duke but receive your follow-up care closer to home, we are happy to coordinate your care with your doctors.

Among the Best Cancer Hospitals in U.S.
Where you receive your cancer care is important. Duke University Hospital's cancer program is ranked among the nation's best by U.S. News & World Report for 2019–2020.
Reviewed: 06/07/2018