Other Skull Base Conditions

Our UCI Health skull base surgical team also treats a variety of conditions that may be a structural abnormality, have a genetic component or be triggered by an infection.

Congenital conditions

• Craniosynostosis is a birth defect of the brain characterized by the premature closure of one or more of the fibrous joints between the bones of the skull (called cranial sutures) before brain growth is complete.
  
  The premature closure of a single suture restricts the growth in some parts of the skull resulting in an abnormal skull shape. Premature closure of many sutures impacts brain growth and development. The first sign of this disorder in a baby is typically an abnormally shaped skull.
  
  Surgery can improve the symmetry and appearance of the head, as well as relieve pressure on the brain and the cranial nerves.

Cysts

• Rathke cleft cysts are usually treated with transsphenoidal surgery, in which the cyst is partially excised and drained. Some patients require an endoscopic endonasal approach (accessing the cyst through the nasal cavity) in order to preserve the pituitary function.
• Arachnoid cysts may need no treatment. However, microneurosurgical techniques and endoscopic minimally invasive surgery represent an alternative approach to remove or drain the cyst.
• Epidermoid cysts are small bumps that develop beneath the skin on the face, neck, trunk and sometimes the genital area. Slow-growing and often painless, they usually don't cause problems or need treatment. However, if the cyst becomes large, swollen or tender the doctor may drain it or surgically remove it.
• Dermoid cysts contain one or more of the three embryologic layers of cells found in a developing fetus: ectoderm, mesoderm and endoderm. Skull base dermoid cysts may be surgically removed using an endoscopic endonasal approach (accessing the cyst through the nasal cavity). Dermoid cysts are usually noncancerous.

Abnormal bone growths

• Fibrous dysplasia is a bone disease that destroys and replaces normal bone with fibrous bone tissue. One or more bones can be affected. Symptoms include pain, sores, difficulty walking, fractures, unusual skin color and endocrine problems. There is no cure for fibrous dysplasia although bone fractures or deformities are treated as are related endocrine disorders.
• Ossifying fibroma is a noncancerous lesion commonly seen in the head and neck regions. Cemento-ossifying fibroma is a hard, fibrous growth that occurs most frequently in the mouth or jaw. It can continue to grow unless treated. Most lesions are treated with surgery. Some patients require bone grafting.
• Osteomas are slow-developing, usually benign tumors formed by the abnormal growth of bone and other tissue that grows next to or within bones, including the skull and facial bones. An osteoma often produces no symptoms, but they can result in pain and inflammation when the tumor presses against a nearby organ. When the tumor grows in the nasal passages, breathing difficulties can result.
  
  Treatment usually involves surgical removal of the obstructing growths, but may also include the use of radiofrequency waves that are passed through the bony tumors with embedded needles.

Other structural abnormalities

• Trigeminal neuralgia is a chronic and painful condition affecting the trigeminal nerve, which carries sensation from the face to the brain. Symptoms can be severe and include episodes of shooting pain that can feel like an electrical shock. The disorder usually affects one side of the face or one spot but can spread over time, becoming more intense and frequent.
  
  Treatment options include medicines, surgery and radiation therapy. Several neurosurgical procedures can be considered for trigeminal neuralgia. Selection of a surgical procedure often depends on the nerve affected, the patient's overall health and personal preference.


• Hemifacial spasm is a nervous system disorder that causes the muscles on one side of the face to twitch sporadically. There are many possible causes of this condition including a blood vessel pressing on a facial nerve, a facial nerve injury or a tumor. Sometimes the spasm spreads to other areas of the face and the twitching becomes continuous.
  
  Hemifacial spasm is often treated with microvascular decompression, a surgical procedure that relieves pressure on the facial nerve. The condition can also be treated with injections of botulinum toxin into the affected areas or, in mild cases, with medication.

For more information or to schedule a consultation, please call 714-456-6966 for neurosurgery services or 714-456-7017 for head and neck surgery.