Minimally Invasive Skull Base Surgery

Minimally Invasive Skull Base Surgery

Minimally invasive skull base surgery is a rapidly evolving field that applies endoscopic technology to remove benign and malignant tumors in the head, neck, and skull base.

Certain tumors, depending on their location, can be removed endoscopically using special tools and scopes that pass through small openings. Tumors of the skull base and paranasal sinuses can be safely accessed and effectively removed through the nasal passages. Just a decade ago, many of these tumors were considered inoperable or required extensive craniotomies to remove.

Since the tumors can be accessed through the nose, there is no need to make facial incisions or drill through the skull. This technique offers direct access to previously inoperable tumors. With this type of procedure, patients can expect fewer complications and shorter hospital stays.

minimally invasive skull base surgery at UCSF
UCSF neurosurgeon Manish Aghi MD, PhD (left) and UCSF otolaryngologist Ivan El-Sayed MD (right) work together to remove a pituitary tumor via minimally invasive skull base surgery.

Here at UCSF, we have some of the best skull base expertise in the United States, including extensive experience with both open and minimally invasive surgical techniques. Our neurosurgeons and otolaryngologists operate on patients together, and collaborate to identify the safest endoscopic routes to access each tumor.

Each patient is thoroughly evaluated by a multidisciplinary team to determine if they are candidates for minimally invasive surgery, but possible conditions include the following:

Cranial Skull Base Tumors*

Sinonasal Malignancies:

  • Esthesioneuroblastoma (olfactory neuroblastoma)
  • Sinonasal neuroendocrine carcinoma
  • Sinonasal undifferentiated carcinoma
  • Squamous cell cancer
  • Adenocarcinoma
  • Melanoma
  • Vascular tumors

Benign Conditions:

  • Encephaloceles
  • Schwannomas
  • Fibro-osseous lesions
  • Optic nerve compression
  • Inverted papilloma
  • Juvenile nasopharyngeal angiofibroma
  • Petrous apex cholesterol granuloma
  • CSF leaks

* Depending on the exact location of the tumor. The team at UCSF will determine whether you are a candidate for minimally invasive skull base surgery.


This content was reviewed by UCSF neurosurgeon, Manish Aghi MD, PhD.