Skull Base Surgery

Skull base tumors can threaten a patient's vision, facial function or hearing, and outcomes are better at high-volume centers with advanced technologists and skilled microsurgeons.

As one of the largest academic health care systems in the Midwest, our team of specialists at Indiana University School of Medicine, partnered with IU Health, treat the most skull base tumors in the state of Indiana. Faculty physicians in the Departments of Otolaryngology—Head and Neck Surgery, Neurological Surgery and Medicine not only treat patients with excellence but also lead research and clinical trials, bringing leading-edge skull base tumor care to the people of Indiana.

Looking for Patient Care?

Schedule an appointment or make a referral with a skull base specialist at IU Health.

Call: 317-944-6467
Fax: 317-968-1038

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364 new visits for skull base conditions in 2024

5 years with the most market share in Indiana*

242 skull base cases in 2024

*Source: Indiana Hospital Association (IHA), Jan.–Sep. 2023

Conditions Treated

Anterior skull base	Lateral skull base
Pituitary adenomas	Acoustic neuroma
CSF leaks	CSF leaks
Chordoma	Paragangliomas
Craniopharyngiomas	Bell's Palsy
Meningiomas	Trigeminal Neuralgia

Program Highlights

Largest academic healthcare system — IU Health — in the Midwest
Nationally recognized for research in the diagnosis and treatment of spontaneous CSF leaks, acoustic neuromas, and pituitary adenomas.
Precision medicine based upon tumor type, location, and patient preferences
Timely consultations completed within an average of seven days
Largest acoustic neuroma program in Indiana focused on facial nerve and hearing preservation
Non-invasive treatment of skull base tumors available with Gamma knife radiosurgery
Multidisciplinary team of experts including fellowship-trained facial plastic surgeons, laryngologists, head and neck oncologists to rehabilitate tumor-related cranial nerve deficits such as facial paralysis, vocal cord paralysis and swallowing dysfunction.
Academic training through Skull Base Fellowships and residency training program at IU School of Medicine

Fellowship Programs

Neuro-oncology/Skull Base

The Department of Neurological Surgery offers a one-year fellowship in managing complex brain tumors and in the operative management of aneurysms and arteriovenous malformations.

Neurotology

The Department of Otolaryngology—Head and Neck Surgery offers a two-year fellowship ranging from neurotology cases in the operating room to practical experience with patients.

Rhinology and Endoscopic Skull Base Surgery

The Department of Otolaryngology—Head and Neck Surgery offers a one-year fellowship in the management of complex rhinologic and neuro-rhinologic conditions.

Research Papers

Totten DJ, Cumpston EC, Schneider W, Yates CW, Shah MV, Nelson RF. Residual Vestibular Schwannomas: Proposed Age-Tumor-Residual (ATR) Staging System to Predict Future Growth. Otol Neurotol. 2024 Dec 1;45(10):1172-1177. doi: 10.1097/MAO.0000000000004339. Epub 2024 Oct 16. PMID: 39439051.

Cumpston EC, Rhodes SD, Yates CW. Advances in Targeted Therapy for Neurofibromatosis Type 2 (NF2)-Associated Vestibular Schwannomas. Curr Oncol Rep. 2023 May;25(5):531-537. doi: 10.1007/s11912-023-01388-3. Epub 2023 Mar 18. PMID: 36933171.

Totten DJ, Connell NT, Howser LA, Colomb E, Sandelski MM, Rabbani CC, Savage JJ, Shah MV, Nelson RF. Facial Nerve Preservation With Inferior Long-Axis Dissection of Large Vestibular Schwannomas. Otol Neurotol. 2023 Jan 1;44(1):66-71. doi: 10.1097/MAO.0000000000003753. PMID: 36509444.

Dougherty MC, Shibata SB, Clark JJ, Canady FJ, Yates CW, Hansen MR. Reduction of sporadic and neurofibromatosis type 2-associated vestibular schwannoma growth in vitro and in vivo after treatment with the c-Jun N-terminal kinase inhibitor AS602801. J Neurosurg. 2022 Sep 9;138(4):962-971. doi: 10.3171/2022.7.JNS22934. PMID: 36087315; PMCID: PMC10193498.

McClelland S 3rd, Combs SE, Halasz LM, Lo SS, Shiue K. Commentary: Fractionated Proton Beam Radiation Therapy and Hearing Preservation for Vestibular Schwannoma: Preliminary Analysis of a Prospective Phase 2 Clinical Trial. Neurosurgery. 2022 Jul 1;91(1):e11-e12. doi: 10.1227/neu.0000000000002021. Epub 2022 Apr 28. PMID: 35471197.

Hawley E, Gehlhausen J, Karchugina S, Chow HY, Araiza-Olivera D, Radu M, Smith A, Burks C, Jiang L, Li X, Bessler W, Masters A, Edwards D, Burgin C, Jones D, Yates C, Clapp DW, Chernoff J, Park SJ. PAK1 inhibition reduces tumor size and extends the lifespan of mice in a genetically engineered mouse model of Neurofibromatosis Type 2 (NF2). Hum Mol Genet. 2021 Aug 12;30(17):1607-1617. doi: 10.1093/hmg/ddab106. PMID: 34075397; PMCID: PMC8369838.

Gehlhausen JR, Hawley E, Wahle BM, He Y, Edwards D, Rhodes SD, Lajiness JD, Staser K, Chen S, Yang X, Yuan J, Li X, Jiang L, Smith A, Bessler W, Sandusky G, Stemmer-Rachamimov A, Stuhlmiller TJ, Angus SP, Johnson GL, Nalepa G, Yates CW, Wade Clapp D, Park SJ. A proteasome-resistant fragment of NIK mediates oncogenic NF-κB signaling in schwannomas. Hum Mol Genet. 2019 Feb 15;28(4):572-583. doi: 10.1093/hmg/ddy361. PMID: 30335132; PMCID: PMC6489415.

Saltagi AK, Saltagi MZ, Kedo M, Shah MV, Nelson RF. Management of Fallopian Canal Spontaneous CSF Leaks, Implications of Elevated Intracranial Pressure: Case Report and Systematic Review of the Literature. Otol Neurotol. 2024 Mar 1;45(3):215-222. doi: 10.1097/MAO.0000000000004107. Epub 2024 Feb 7. PMID: 38361289.

Totten DJ, Schueth E, Saltagi MZ, Rabbani C, Harris AH, Tressman D, Hohmann SF, Nelson RF. Trends in Spontaneous Cerebrospinal Fluid Leak Repairs in the United States, 2009-2018. Otol Neurotol Open. 2022 Oct 27;2(4):e021. doi: 10.1097/ONO.0000000000000021. PMID: 38516580; PMCID: PMC10950128.

Saltagi MZ, Fraser AL, Alwani MM, Mosier KM, Nelson RF. Cerebrospinal Fluid Leaks From the Lateral Ventricle: A Case Series. Otol Neurotol. 2021 Sep 1;42(8):e1111-e1117. doi: 10.1097/MAO.0000000000003211. PMID: 34121080.

Sharma D, Tucker BJ, Millay DS, Rubel KE, Saltagi M, Nelson RF, Illing EA, Ting JY. Calvarium Thinning in Patients with Spontaneous Cerebrospinal Fluid Leaks of the Anterior Skull Base. Laryngoscope. 2021 Jun;131(6):1271-1276. doi: 10.1002/lary.29130. Epub 2020 Sep 23. PMID: 32965699.

Alwani MM, Saltagi MZ, MacPhail ME, Nelson RF. Middle Cranial Fossa Repair of Temporal Bone Spontaneous CSF Leaks With Hydroxyapatite Bone Cement. Laryngoscope. 2021 Mar;131(3):624-632. doi: 10.1002/lary.28761. Epub 2020 May 19. PMID: 32427386.

Alwani M, Bandali E, Van Buren L, Yates CW, Nelson RF. Audiologic Improvement Following MCF Approach for Spontaneous Cerebrospinal Fluid Leaks. Otol Neurotol. 2019 Sep;40(8):1026-1033. doi: 10.1097/MAO.0000000000002302. PMID: 31157725.

Brown NJ, Gendreau J, Chakravarti S, Abraham BM, Mehkri Y, Kuo CC, Chowdhury N, Cohen-Gadol A. The influence of facility type on intracranial meningioma treatment and outcomes: predicting overall survival using the National Cancer Database. J Neurosurg. 2023 Aug 18;140(2):350-356. doi: 10.3171/2023.6.JNS231145. PMID: 37877982.

Wang JZ, Patil V, Liu J, Dogan H, Tabatabai G, Yefet LS, Behling F, Hoffman E, Bunda S, Yakubov R, Kaloti R, Brandner S, Gao A, Cohen-Gadol A, Barnholtz-Sloan J, Skardelly M, Tatagiba M, Raleigh DR, Sahm F, Boutros PC, Aldape K; International Consortium on Meningiomas (ICOM); Nassiri F, Zadeh G. Increased mRNA expression of CDKN2A is a transcriptomic marker of clinically aggressive meningiomas. Acta Neuropathol. 2023 Jul;146(1):145-162. doi: 10.1007/s00401-023-02571-3. Epub 2023 Apr 24. Erratum in: Acta Neuropathol. 2023 May 12;: PMID: 37093270; PMCID: PMC10261216.

El Ahmadieh TY, Nuñez M, Vigo V, Abou-Al-Shaar H, Fernandez-Miranda JC, Cohen-Gadol AA. Frontotemporal-Orbitozygomatic Approach and Its Variants: Technical Nuances and Video Illustration. Oper Neurosurg (Hagerstown). 2022 Dec 1;23(6):441-448. doi: 10.1227/ons.0000000000000370. Epub 2022 Oct 26. PMID: 36318722.

Dos Santos Silva J, Schreiner CA, de Lima L, Brigido CEPL, Wilson CD, McVeigh L, Acchiardo J, Landeiro JA, Acioly MA, Cohen-Gadol A. Volumetric measurement of intracranial meningiomas: a comparison between linear, planimetric, and machine learning with multiparametric voxel-based morphometry methods. J Neurooncol. 2023 Jan;161(2):235-243. doi: 10.1007/s11060-022-04127-z. Epub 2022 Sep 5. PMID: 36058985.

Chang LS, Oblinger JL, Smith AE, Ferrer M, Angus SP, Hawley E, Petrilli AM, Beauchamp RL, Riecken LB, Erdin S, Poi M, Huang J, Bessler WK, Zhang X, Guha R, Thomas C, Burns SS, Gilbert TSK, Jiang L, Li X, Lu Q, Yuan J, He Y, Dixon SAH, Masters A, Jones DR, Yates CW, Haggarty SJ, La Rosa S, Welling DB, Stemmer-Rachamimov AO, Plotkin SR, Gusella JF, Guinney J, Morrison H, Ramesh V, Fernandez-Valle C, Johnson GL, Blakeley JO, Clapp DW; Synodos for NF2 Consortium. Brigatinib causes tumor shrinkage in both NF2-deficient meningioma and schwannoma through inhibition of multiple tyrosine kinases but not ALK. PLoS One. 2021 Jul 15;16(7):e0252048. doi: 10.1371/journal.pone.0252048. PMID: 34264955; PMCID: PMC8282008.

Aljuboori Z, Alhourani A, Woo S, Hattab E, Yusuf M, Nelson M, Andaluz N, Ding D, Savage J, Williams B. Trends in the Management Paradigms of Intracranial Meningioma. J Neurol Surg B Skull Base. 2021 Apr;82(2):208-215. doi: 10.1055/s-0039-1697036. Epub 2019 Sep 17. PMID: 33777636; PMCID: PMC7987396.

Cohen-Cohen S, Rindler R, Botello Hernandez E, Donegan D, Erickson D, Meyer FB, Atkinson JL, Van Gompel JJ. A Novel Preoperative Score to Predict Long-Term Biochemical Remission in Patients with Growth-Hormone Secreting Pituitary Adenomas. World Neurosurg. 2024 Feb;182:e882-e890. doi: 10.1016/j.wneu.2023.12.076. Epub 2023 Dec 18. PMID: 38123128.

Donegan D, Bornhorst J, Van Gompel J, Atkinson J, Theobald JP, Meyer FF, Link MJ, Peris-Celda M, Spears G, Erickson D. Postsurgical utility of copeptin for the prediction of postoperative arginine vasopressin deficiency. J Neurosurg. 2023 Nov 10:1-9. doi: 10.3171/2023.8.JNS23418. Epub ahead of print. PMID: 37948691.

Abdollahifard S, Taherifard E, Sadeghi A, Farrokhi A, Cohen-Gadol AA, Palmisciano P. Early Morning Cortisol Level as a Predictive Factor for Long-Term Glucocorticoid Replacement After Pituitary Surgery: A Systematic Review and Meta-Analysis. World Neurosurg. 2023 Aug;176:168-178. doi: 10.1016/j.wneu.2023.05.029. Epub 2023 May 16. PMID: 37201788.

Xu Y, Mohyeldin A, Asmaro KP, Nunez MA, Doniz-Gonzalez A, Vigo V, Cohen-Gadol AA, Fernandez-Miranda JC. Intracranial Breakthrough Through Cavernous Sinus Compartments: Anatomic Study and Implications for Pituitary Adenoma Surgery. Oper Neurosurg (Hagerstown). 2022 Aug 1;23(2):115-124. doi: 10.1227/ons.0000000000000291. Epub 2022 Jun 10. PMID: 35838451.