Our Nemours specialists are also professors at the Sidney Kimmel Medical College at Thomas Jefferson University. That means our experts are helping to teach the experts of tomorrow. The skull base team at Thomas Jefferson University Hospital (TJU) are also our partners — and they're leaders in making the minimally invasive skull base surgical technique better for kids. In fact, TJU’s skull base experts created many of the techniques and invented instruments used for this cutting-edge operation. TJU’s most well-known skull base surgeons work side-by-side with our Nemours specialists to offer a unique approach for children with rare problems of the skull base and sinuses (the moist air spaces within the bones of the face around the nose).

Together, our Nemours Minimally Invasive Endoscopic Cranial Base Surgery Program helps kids get better faster. Children tend to have less pain, no scars, fewer complications, and less chance of damage to other parts of the brain.

Learn More About Skull Base Surgery

The conditions we treat with skull base surgery include:

• aneurysmal bone cysts (a noncancerous growth in the bone)
• cerebrospinal fluid leaks (when there’s a leak of the clear, colorless liquid that delivers nutrients to the brain and spinal cord and “cushions” them for protection)
• chordomas (tumors along the spine)
• craniopharyngiomas (brain tumors near the pituitary gland, a tiny organ at the bottom of the brain that makes hormones that regulate growth and reproduction)
• encephaloceles (when the brain has a hernia — an opening or weakness in the wall of a muscle, tissue or membrane that normally holds an organ in place)
• fibro-osseous lesions (a group of growths on the jaws, face or skull that are made up of tissues that are hard like bones)
• juvenile nasopharyngeal angiofibromas (noncancerous tumors in preteen and teen boys’ nasopharynx, where the airways in the nose and mouth meet)
• meningiomas (tumors on the lining of the brain)
• meningoceles (when the spinal canal — the area that contains the spinal cord — isn’t fully formed)
• pituitary tumors (tumors on the pituitary gland)
• sarcomas (cancers of the connective tissue, which hold the body’s tissues and organs together)
• teratomas (tumors that may be made up of things like teeth, bone, muscle and hair; includes dermoid tumors — when a baby is born with this kind of growth on the skin, often near the eye)

Caring for children with tumors and other conditions that need skull base surgery takes a team of specialists. Depending on your child’s condition, your care team may include doctors and services in:

• anesthesiology
• endocrinology
• interventional radiology
• neuroradiology (imaging tests to look at the brain, head, skull or spine)
• neurosurgery
• oncology
• ophthalmology
• otolaryngology (head and neck surgery)
• pediatric intensive care
• plastic surgery

To get ready for surgery, doctors may order a computed axial tomography (CAT or CT) scan or magnetic resonance imaging (MRI). A CAT scan uses a special doughnut-shaped X-ray machine to provide detailed views of the body. An MRI is also a large doughnut-shaped scanner with a tunnel in the center that uses a magnetic field and sound waves to give detailed images. Your child also may need other tests, treatments and exams before surgery.

Skull base operations used to require large incisions (cuts). Now we can do these procedures using smaller, hidden cuts or by going through natural openings like the nose. At the Nemours Minimally Invasive Endoscopic Cranial Base Surgery Program, we use advanced equipment and computer navigation systems to make the surgery as precise as possible.

Regional Skull Base Surgery Highlights