Endoscopic Skull Base and Pituitary Programs: Pioneering Minimally Invasive Surgeries For Faster Recovery

The University of Michigan’s Cranial Base and Pituitary programs diagnose and treat benign and malignant tumors involving the cranial base and pituitary regions, cerebrospinal fluid leaks, encephaloceles and traumatic injuries to the face and skull. Endoscopic skull base surgery is an increasingly used technique that does not require facial incisions.

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Resection of suprasellar craniopharyngioma

“Minimally invasive endoscopic approaches to the skull base have largely replaced the more invasive transcranial and transfacial approaches that were the mainstay of treatment for decades,” says Stephen E. Sullivan, M.D. Sullivan is director of the minimally invasive skull base program based in the departments of otolaryngology and neurosurgery and the minimally invasive pituitary program.

“We’re able to access most skull base brain tumors endoscopically, just through the nostrils. We actually get better visualization than we could previously in an open operation,” he says. Computer image guidance like a GPS is often used.

This approach causes patient lengths of stays to come down significantly. For the patient, it means no incisions, less pain and quicker recoveries.

“We evaluate patients in a multidisciplinary manner with all of the necessary consultants.  One

Resection of pre-pontine craniopharyngioma

Resection of pre-pontine craniopharyngioma

stop shopping, so to speak,” says Sullivan.

High Volumes and Types of Care
Sullivan’s programs perform about 225 skull base surgeries a year, approximately 120 of which are pituitary surgery. The remaining types of tumors are meningiomas, chordomas, craniopharyngiomas, esthesioneuroblastomas and sinonasal malignancies that involve the skull base.

Sullivan’s clinic takes a multidisciplinary approach in assessing patients by including all the specialists involved, including neurosurgery; ear, nose and throat; neuro-ophthamology and radiology. “Together, we come to joint decisions about care,” Sullivan says.

“We are one of the highest volumes centers in the country, certainly in the Midwest.”

For the Referring Physician
His area also has ongoing research looking at, for example, chordoma treatments and cells lines, and the genetic profile of chordoma cells. “It’s important for patients to participate in clinical trials.

“I want referring physicians to know that, while these are complicated tumors, the treatment paradigms are changing very rapidly right now. What wasn’t possible even a year ago is indeed possible now,” Sullivan says. “We’re happy to field any and all calls.”

Skull Base Program
  • Patients needing surgery can be seen in clinic within 1 or 2 weeks
  • 225 skull base surgeries a year, 120 of which are pituitary surgeries

 Find more information at UofMhealth.org/CranialBase or call M-LINE at 1-800-962-3555.

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