Diagnosis and Treatment
Our UCI Health skull base team is thoroughly versed in the latest methods to diagnose and treat diseases and disorders that affect the delicate and complex region beneath the brain that allows us to see, hear, breathe, smell and taste.
As a university medical center, our specialists have access to the most advanced diagnostic tools, including the latest in:
- Magnetic resonance imaging (MRI), which uses powerful magnets and radio waves to create detailed images of the organs and tissues within the area of the body being scanned. These digital images, or slices, can be assembled to give three-dimensional views at differing angles of the area of the body being studied.
- Computed tomography (CT), which uses X-rays to create three-dimensional images of a particular area of the body. The CT scanner creates separate cross-section images as it rotates the portion of the body being scanned. These cross-section images, or slices, are then stacked together to create a three-dimensional image of the area being studied.
- Positron emission tomography (PET), which uses a radioactive substance called a tracer to examine how organs and tissues are functioning — unlike MRI or CT imaging techniques, which show the structure of organs and the blood flow to and from them.
- Functional MRI (fMRI), which uses the same magnetic and radio wave scanning technique to measure neural activity and blood flow in the cranial region.
- Magnetic resonance spectroscopy (MRS), which uses magnets and radio waves to measure biochemical changes in the brain and head area, especially the presence of tumors.
Conditions in the base of the skull can be difficult to see and reach. In the past, treatment for these disorders often required opening up the skull. However, in recent years, ear, nose and throat (ENT) surgeons and neurosurgeons have made significant strides in developing techniques to reach these areas without disturbing sensitive and vital surrounding tissues.
Minimally invasive surgery
Skull base surgery may be done with a minimally invasive endoscopic procedure in which instruments are inserted through the natural openings—also called natural orifices—in the skull: the mouth or nose. For example, endoscopic endonasal surgery is performed through the nose. These surgeries require no incisions and cause no disfigurement. Patients often recover faster and with fewer side effects.
In some cases, a small incision is made just above the eyebrow to allow the insertion of instruments to remove tumors. Another new surgical method is known as endoport surgery. During this procedure, a surgeon drills a tiny hole through the skull and inserts a small tube deep into the brain to remove a tumor that would otherwise be difficult to access.
Many of our skull base surgeons are experts in the use of stereotactic radiosurgery systems. These systems deliver tiny beams of radiation aimed precisely at the tumor. The highly focused beams deliver a maximum dose of radiation while minimizing harm to healthy, surrounding tissues.
Ultrasonic bone removal
Ultrasonic bone removal is a novel procedure used to remove bone in critical areas around the brain or cranial nerves. Instead of using a high-speed drill around the structures of the brain, this device can gently remove bone while minimizing damage to the surrounding structures.
We also perform traditional open surgery for skull base conditions.
Other treatments and therapies include:
- Botulinum toxin
- Endovascular embolization
- Neutron beam therapy
- Photodynamic therapy
- Radiofrequency ablation
- Targeted radionuclide therapy
For more information, call 714-456-7017 for head and neck surgery or 714-456-6966 for neurosurgery.