Areas of Expertise
Skullbase Surgery & Vestibular Schwannoma
A technically demanding discipline
Processes of the skullbase are lying deep and in immediate vicinity to functional important structures, like brain supplying arteries, the optic nerve, other cranial nerves (e.g. for facial expression, swallowing, eye movements), brain stem and regulatory centers of the diencephalon (hormones, body rhythmicity), in the area of the orbital cone, or in the vicinity of the hearing- and vestibular organ of the petrous bone. The combination of special microsurgical skullbase techniques with minimized approaches through the skull and the gentle removal of skullbase lesions requires further developed microsurgical skills and knowledge. As such the demand on the surgical capabilities is quite high. The combination of these microsurgical techniques with minimized approaches allows to remove tumor, treat vascular malformations and nerve lesions (e.g. trigeminal neuralgia) or to biopsy over very small corridors efficiently and tissue sparing. Besides my preference to operate without the use of retractors, we are helped by neuronavigation, high end surgical microscopes and cranial endoscopy. A whole array of different intraoperative recordings help neurosurgeons to monitor the sustained integrity of particular brain- and cranial nerve functions (“Neuromonitoring”). For each process we strive to find an individual anatomic route in order to minimize the patient risks. In dependance on the risk-benefit analysis complete tumor removal is not always intended or possible. Modern skullbase surgery is supplemented by radiation therapy for tumor rests. I do consider aesthetic aspects. For redo surgery or severe defects of the cranial vault or facial skull (bone defects, marked asymmetries) we offer reconstruction. For this we use material from your own body (e.g. “autologous“ fat, bone, or fascia) or patient specific implants, which are individually fabricated for precise fit (CAD implants).
Vestibular schwannomas, erroneously also called „acoustic neuromas“are benign tumors of the vestibular nerve, which produce tinnitus hearing loss, and brain stem symptoms. Depending on size and symptoms they are treated or followed with imaging. Typical treatment options are microsurgical removal or radiosurgery/radiotherapy. The treatment of choice depends on size, patient condition and preference. If large, microsurgical removal under neuromonitoring is the preferred method (e.g. brain stem pressure and displacement).
Disorders & keywords
- Vestibular schwannoma (misnomer „acoustic neuroma“)
- Schwannoma („Neurinoma“)
- Bone & skull tumors
- pituitary adenoidal
- Deep lying brain aneurysms
- Cranio-orbital tumors with Exophthalmus (eye-protrusion)
- Reconstruction of skull, cranial reconstruction, reconstruction of bony orbital cone