Skull Base | Complex Conditions

The skull base is the area behind the eyes and nose that slopes down to the back of the head. It forms the floor, or base, of the skull. The bones that form the skull base also form the eye socket, roof of the nasal cavity, some of the sinuses, and the bones that surround the inner ear.

This is one of the most complex areas of the body in which to address medical issues and /or perform surgery because it contains many of the facial nerves responsible for hearing, seeing, and facial movement.

Additionally, the area is densely packed with vessels keeping the brain supplied with oxygen and is the connection between the brain and the brainstem, or spinal cord.


Skull base disorders include, but are not limited to the following, and can cause serious complications, such as compromised vision or hearing and effects on growth, hormone production, fertility, and balance.


You may have many possible symptoms from a growth or disorder in the skull base area. Symptoms will depend on the size, type, and location of the growth or abnormality, and may include:

  • Facial pain
  • Headache
  • Dizziness
  • Visual problems
  • Numbness
  • Weakness of the face
  • Hearing loss or ringing in the ears
  • Nasal congestion or frequent sinus infections


To diagnose disorders of the skull base, physicians will rely on a host of tests and exams including:

  • Physical exam
  • Neurological exam
  • Imaging studies — CT scan, MRI, bone scan, positron emission tomography (PET) scan.
  • Testing for balance, cranial nerves, muscle activity, vision, and hearing may all be checked.


Treatment for skull base issues may include endoscopic skull base surgery, radiation therapy, chemotherapy, rehabilitation, or a combination of these approaches.

For some people with benign tumors, treatment may be simple tumor observation with repeat MRIs over time.


Endoscopic skull base surgery in this delicate, compact area typically requires a multi-disciplinary approach to ensure best outcomes. The ENT surgeon will team with neurotologists, radiation oncologists, neurosurgeons, medical oncologists, endocrinologists, pathologists, ophthalmologists, therapists, and others as needed.