- World-class expertise in treating all types of skull base tumors and conditions, even those that other health centers consider too challenging. Go to Conditions Treated
- Advanced surgical treatments, including minimally invasive and new scarless options. Go to Treatments
- Clinical trials that provide access to novel treatment approaches. Go to Clinical Trials
- A team approach with a variety of specialists working in close coordination on a care plan customized to your physical, emotional, and spiritual needs. Go to Your Care Team
- Comprehensive support services including educational workshops, fitness classes, and support groups to restore your high quality of life. Go to Support Services
- Ease of access with dedicated nurse coordinators who partner with you and your family to guide you through each step of your care. Go to Connecting to Care
At Stanford Health Care, we effectively treat all conditions of the skull base, including those that other health centers consider too challenging to attempt. We offer superior outcomes because our team works closely to collaborate on your care.
Each member of our team has specialized training in the diagnosis and treatment of conditions affecting the underside of the brain and skull base, such as:
- Chondrosarcoma
- Chordoma
- Cranial nerve schwannoma
- Craniopharyngioma
- Cushing’s syndrome (Cushing's disease)
- Inflammatory pseudotumor
- Meningioma
Skull Base Condition Treatments
The Stanford Health Care Skull Base Surgery Program is recognized globally for developing treatments for skull base conditions. We work tirelessly to translate our discoveries into transformative, compassionate care.
Our skull base surgery team gives you personalized treatment recommendations based on your condition, overall health, and lifestyle. We partner with you and your family for ongoing care, from diagnosis through treatment and follow-up management.
INNOVATION HIGHLIGHTS
- Stanford Medicine skull base surgeons have pioneered and refined endoscopic endonasal surgery (EES) for multiple lesions.
- Our skull base rhinologists have developed advanced methods to preserve your sense of smell and maximize your quality of life after EES.
- Stanford Medicine skull base and pediatric neurosurgeons have performed EES for craniopharyngioma in the youngest patient ever reported.
- We use our unique virtual reality program and 3D images of your skull base to prepare for your treatment.
- The Stanford Skull Base Surgery Program is leading innovations in teaching and education for surgeons around the world.
- Stanford Medicine neurosurgeons revolutionized skull base treatment by inventing and expanding the use of CyberKnife, a radiation therapy device, to treat conditions that were thought to be untreatable.
Stanford Medicine Neurosurgeon Performs Successful Endoscopic Endonasal Surgery on a Two-year-old – the Youngest EES Patient Ever
It’s the decision no parent imagines they will face: what kind of treatment to pursue for a two-year-old child, after learning that his vomiting, lethargy, and seizures were caused by a brain tumor.
Ari Ellman’s best option was also the riskiest: he needed special surgery to remove the tumor, but it had never been performed on a patient so young. Dr. Juan Fernandez-Miranda, the head of Stanford’s Skull Base Surgery program, spent hours practicing in a virtual OR and on a 3D printed model of Ari’s tiny skull to successfully remove Ari’s tumor piece-by-piece.
Juan Carlos Fernandez-Miranda, MD
Chief of the Skull Base Surgery Division
If you have a slow-growing tumor, we may recommend monitoring it for signs that it may be worsening and need treatment. Your doctor works with you to determine how often and what type of testing you need.
Surgery is usually the first treatment for many skull base conditions. Our surgeons are globally recognized for their understanding of skull base anatomy, technical mastery, and pioneering contributions, as well as their careful planning and preparation for complex cases.
We perform these skull base surgeries:
- Endoscopic endonasal surgery (EES): A scarless approach that lets the surgeon treat tumors near the skull base by inserting an endoscope (thin tube with a camera and light) through the nose
- Minimally invasive keyhole surgery: A minimally invasive technique that lets the surgeon reach tumors through a tiny opening in the skull
- Transcranial skull base surgery: Surgery performed through the skull that removes tumors at the base of the brain or skull
- Transorbital skull base surgery: A minimally invasive technique that treats growths or tumors behind the eyes, at the base of the skull, or close to the sinuses
- Transtemporal skull base surgery: An innovative procedure to remove tumors impacting the base of the skull, ears, upper neck, and surrounding blood vessels and nerves
Your doctor may recommend cancer medications. Some work to slow or stop the tumor growth and spread. Others stimulate the immune system to target and attack specific cancer cells. Drug therapies for treating cancerous tumors include:
- Chemotherapy: Powerful medications used to treat brain tumors by preventing cancer cells from growing
- Hormone therapy: Treatment that slows or stops the growth of cancers that depend on hormones to grow
- Immunotherapy: Medications that increase your immune system’s ability to recognize and fight cancer cells
- Targeted therapy: Medications that target specific genetic changes (mutations) in cancer cells
To relieve your symptoms, your doctor may recommend medications such as:
- Anticonvulsants to reduce the risk of seizures
- Steroids to reduce swelling in your brain and spinal cord
We may recommend radiation therapy to help treat your condition, while protecting healthy surrounding tissue. Radiation options include:
- CyberKnife radiosurgery targets tumors with high-dose radiation to kill them or keep them from growing
- 3D conformal radiation therapy (3D-CRT) uses 3D imaging to focus radiation treatment from a variety of angles to conform to the shape of your tumor
- Intensity-modulated radiation therapy (IMRT) is similar to 3D-CRT but your radiation oncologists regulate the intensity of treatment to the various densities of your tumor
In certain cases, we analyze tumor cells for specific genetic markers that might respond to targeted therapies. We review the results with Stanford’s Molecular Tumor Board to determine the right treatment options for you.
We offer genetic testing and counseling to identify gene mutations that may increase the risk of hereditary conditions. We guide you and your family through the findings and important personal decisions.
Family risk management is a partnership between our Neurogenetic Oncology Program and Cancer Genetics Program. Learn more about our cancer risk assessment with genetic testing and counseling.
Care for neurological disorders goes beyond medical treatments. We encircle you and your family with supportive services to help treat your mind, body, and soul.
Innovation Through Clinical Research
Stanford Health Care Neuroscience actively participates in groundbreaking research and clinical trials to evaluate new and better ways to diagnose, treat, and manage neurological disorders. Participating in a trial may give you access to experimental therapies that are not available otherwise. We also partner with the Wu Tsai Neurosciences Institute to better understand the brain, develop new treatments for brain disorders, and promote brain health.
Clinical Trials
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest, advanced clinical trials.
Open trials refer to studies that are currently recruiting participants or may recruit participants in the near future. Closed trials are not currently enrolling, but similar studies may open in the future.
A diagnosis of a neurological condition—and the changes it may bring—can be unsettling. We offer you and your caregivers the personalized support you need at every step. Your team listens to you and develops a plan for your situation. And you’ll work with the same team from diagnosis throughout treatment, so we can get to know you and your needs.
Each person’s experience is unique, which is why we provide personalized care. Our team tailors treatment and supportive services to meet your individual needs.
Your Doctors
Interventional Neuroradiologist
Interventional neuroradiologists use imaging studies such as CT scans and MRIs to diagnose and treat conditions of the central nervous system, head, neck, and spine.
View All {0} Interventional Neuroradiologists »Neuroendocrinologist
Neuroendocrinologists diagnose and treat patients with diseases of the endocrine system. Our neurosurgeons partner with neuroendocrinologists to treat pituitary tumors.
View All {0} Neuroendocrinologists »Neurosurgeon
A neurosurgeon is a physician who specializes in the diagnosis and surgical treatment of disorders of the central and peripheral nervous system.
View All {0} Neurosurgeons »Neurotologist
A neurotologist is a type of otolaryngologist (ENT) who provides medical and surgical care of patients with diseases that affect the ears, balance system, temporal bone, skull base, and related structures of the head and neck.
View All {0} Neurotologists »Rhinologist
A rhinologist is a type of otolaryngologist (ENT) who has unique expertise in the medical and surgical treatment of nasal and sinus disorders.
View All {0} Rhinologists »Radiation Oncologist
Radiation oncologists specialize in using high-energy X-rays and other radiation therapy such as CyberKnife to treat cancerous and noncancerous brain and spinal cord tumors. Radiation can destroy cancer cells and prevent them from spreading, and it can destroy noncancerous tumor tissue. Using advanced technologies, radiation oncologists precisely target tumor cells to avoid damaging nearby healthy tissue.
View All {0} Radiation Oncologists »Advanced Practice Provider
Our oncology-certified health care providers work with your oncologist to help with diagnosis and treatment. APPs may recommend medications, lifestyle changes, and services such as genetic counseling. An APP can be a nurse practitioner (NP), physician assistant (PA), or clinical nurse specialist (CNS).
View All 7 Advanced Practice Providers »Extended Care Team
Interventional Neuroradiologist
Interventional neuroradiologists use imaging studies like CT scans and MRIs to diagnose and treat conditions of the central nervous system, head, neck, and spine.
View All {0} Interventional Neuroradiologists »Neuroanesthesiologist
Neuroanesthesiologists specialize in using medications to block pain, help you relax, or make you unconscious for spine and brain tumor procedures. Neuroanesthesiologists also monitor your vital functions such as breathing, blood pressure, and heart rate during surgery. Depending on the type of surgery you have, you may need local (small area), regional (larger area), or general (overall) anesthesia.
View All {0} Neuroanesthesiologists »Neuroendocrinologist
Neuroendocrinologists diagnose and treat patients with diseases of the endocrine system. Our neurosurgeons partner with neuroendocrinologists to treat pituitary tumors.
View All {0} Neuroendocrinologists »Neuro-ophthalmologist
A neuro-ophthalmologist specializes in visual problems related to the nervous system, including loss of sight due to injury to the brain or the optic nerves.
View All {0} Neuro-ophthalmology Specialists »Neuropathologist
Neuropathologists specialize in diagnosing conditions of the brain and nervous system through microscopic evaluation of tissue sampled during biopsy or surgery.
View All {0} Neuropathologists »Neuroradiologist
A neuroradiologist uses imaging studies like CT scans and MRIs to diagnose conditions of the central nervous system, head, neck, and spine. You may not meet your neuroradiologist, since these doctors usually work behind the scenes to determine your diagnosis.
View All {0} Neuroradiologists »Oculoplastic Surgeon
An oculoplastic surgeon is an ophthalmologist who specializes in the plastic and reconstructive surgery of eyelids, eyebrows, forehead, cheeks, the bones around the eye, and the system of ducts that deliver tears.
View All {0} Ophthalmic Plastic And Reconstructive Surgeons »Support Services
Your wellness is our top priority. As part of your care, we design a wellness plan to support you and your family before, during, and after treatment.
We offer a wide array of support services to help you to feel your best. Contact our Neuro Care Services for your personal support plan.
We make access to care as simple as possible. We anticipate what you need and provide support when you need it. Our network of locations puts our services within your reach. User-friendly digital health tools help you stay connected with your care team. We accept most insurance plans and offer discounted transportation, short-stay options, and international travel and translation services. We help make sense of the details, so you can make decisions that are right for you.
At the Stanford Health Care Skull Base Surgery Program, we make accessing care easy and convenient. We make every effort to coordinate your appointments so that you can see multiple providers, as needed, during a single visit.
For Referring Physicians
PHYSICIAN HELPLINE
Fax: 650-320-9443
Monday–Friday, 8 a.m.–5 p.m.
Stanford Health Care provides comprehensive services to refer and track patients, as well as the latest information and news for physicians and office staff. For help with all referral needs and questions, visit Referral Information.
You may also submit a web referral or complete a referral form and fax it to 650-320-9443 or email the Referral Center at ReferralCenter@stanfordhealthcare.org.
HOW TO REFER
Email or fax a skull base surgery referral form with supporting documentation to ReferralCenter@stanfordhealthcare.org or 650-320-9443.
To request an appointment with a neurosurgeon, call 650-497-7777.
To request an appointment with a head and neck surgeon, call 650-723-5281.
To request an appointment with a radiation oncologist, call 650-498-6000.
To request an appointment with an interventional radiologist, call 650-723-6469.