Cranial base surgery has a long tradition at the University of Pittsburgh. The UPMC Center for Cranial Base Surgery—under the current direction of Paul Gardner, MD, and Georgios Zenonos, MD, in the Department of Neurological Surgery and Carl Snyderman, MD, MBA, in the Department of Otolaryngology—is the first skull base center to be established in North America and has pioneered both transcranial microscopic and endoscopic endonasal approaches to the skull base and brain. Together with Eric Wang, MD, in the Department of Otolaryngology they continue to advance the field through new approach development and refinement as well as molecular strategies for treating skull base disease. They also work in regular collaboration with L. Dade Lunsford, MD, who established the first Gamma Knife center in North America at UPMC in 1987, and was also the first to introduce radiosurgery for the non-operative treatment of skull base tumors.
Experts at the UPMC Center for Cranial Base Surgery continue to lead the field of minimally invasive brain surgery by developing new techniques, tools and approaches that have made it possible to access many tumors, regardless of size. Since 1997, more than 3,900 endonasal surgeries have been performed in adults and children, making UPMC one of the busiest centers in the world for the surgical treatment of tumors of the pituitary region and cranial base. By combining this innovative approach with other minimally invasive approaches, such as transorbital and endoscopic-assisted retromastoid and keyhole approaches, as well as the full complement of standard skull base approaches, the team at UPMC provides a full array of options for cutting-edge treatment of skull base disease. In addition, the Center for Cranial Base Surgery is being designated a Center of Excellence for pituitary tumors by UPMC.
Drs. Gardner, Snyderman, Zenonos and Wang, along with Tonya Stefko, MD, from the Department of Ophthalmology, and Barry Hirsch, MD, and Andrew McCall, MD, otologic surgeons from the Department of Otolaryngology, comprise a team of experts in cranial base surgery, advancing patient care through clinical outcomes studies, in-depth anatomical study, molecular science and genetics research and an international training program. Supported by expert physician assistants Emily Guerriero and Rachel Rogers, and an experienced subspecialty nursing team, patients are evaluated and guided through even the most complex, multidisciplinary care.
The concept of team surgery allows the center to select the best surgical approach for each tumor, with a surgical plan designed around the particular needs of the individual patient. Treatment is designed to offer the best surgical outcome with the least side effects and maximal preservation of function. A full array of transcranial approaches, minimally invasive keyhole approaches and endoscopic endonasal approaches are routinely applied with proven and studied success. The UPMC Center for Cranial Base Surgery is also a major teaching destination for surgeons and other health care professionals looking to learn more about these techniques. Faculty teach three courses a year at UPMC, featuring live surgery and hands-on laboratory work. They also travel the world teaching these procedures to the next generation of skull base surgeons.