By the term skull base we mean the level formed by various bones of the skull that separates the brain from other structures of the head, such as the orbit, the nasal cavity, the paranasal sinuses, and the ear. It is divided into the anterior, middle, and posterior–lateral skull base. The skull base is an extremely complex region with multiple openings through which the spinal cord, numerous blood vessels, and nerves pass. For this reason, its surgical approach is particularly demanding and requires excellent knowledge of anatomy, experience, and advanced surgical skills.
Pathological conditions occur in the skull base region, such as benign and malignant tumors, inflammations and abscesses, trauma, and congenital anomalies. For many years, conventional (open) surgical methods were the only way to treat these conditions. In recent years, the application of modern, minimally invasive methods—such as the use of the endoscope—has enabled us to treat the skull base in a way that is less traumatic for the patient. In the endoscopic approach, the necessary surgical instruments are introduced through natural openings of the skull, such as the nose, or through other small openings created in the skull. It should be noted that even today, in cases of large skull base tumors, the conventional open approach may be required, possibly in combination with the endoscopic technique.
Skull base surgical procedures require specialization, experience, and collaboration within a team of specialized physicians from different disciplines (Neurosurgeons, Otorhinolaryngologists, Radiologists).
Such disorders include pituitary adenomas, skull base meningiomas, craniopharyngiomas, chordomas, cerebrospinal fluid leakage (rhinorrhea), skull base defects, meningoceles and encephaloceles, vascular anomalies, tumors of the nose and paranasal sinuses with extension toward the skull base, acoustic neuromas (vestibular schwannomas), jugular paragangliomas, and others.
The Skull Base Surgery Team of Nicosia General Hospital, consisting of physicians from the Neurosurgery and Otorhinolaryngology Departments, regularly performs specialized and highly complex procedures on the anterior, middle, and posterior–lateral skull base.
Among the procedures performed are:
The Multidisciplinary Skull Base Surgery Team of Nicosia General Hospital is supported by modern equipment, such as state-of-the-art surgical microscopes, endoscopes and endoscopic towers (4K), an intraoperative neuronavigation system, and systems for intraoperative monitoring of central nervous system function (e.g., monitoring of movement, sensation, and cranial nerve function).
Endoscopic surgery of the anterior skull base
Pituitary gland adenoma
Anterior skull base meningioma (Olfactory groove meningioma)
Jugular foramen paraganglioma (Glomus jugulare tumor)
Acoustic neuroma – Vestibular schwannoma
Bibliography
Karampouga M, Patel B, Phoominaonin IS, Stefko ST, Choby G, Wang EW, Snyderman CH, Zenonos GA, Gardner PA. Lateral Orbitotomy for Trigeminal Schwannomas: Surgical Technique, Outcomes, and Limitations. Oper Neurosurg. 2026 Feb 4. doi: 10.1227/ons.0000000000001883. Epub ahead of print. PMID: 41636523.
https://pubmed.ncbi.nlm.nih.gov/41636523/
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