Radiosurgery of the Skull Base: A Case-Based Approach

Siviero Agazzi is Chief of Cranial Surgery and Chief of Radiosurgery at the University of South Florida and has a 15 year experience of training residents and fellows in the fields of open skull base surgery and radiosurgery for skull base diseases. He is also serving as vice president of the North American Skull Base Society. Lawrence B. Berk is the primary Radiation Oncologist for CNS tumors at the University of South Florida. Together with Dr Agazzi and the other University of South Florida Neurosurgeons, has performed hundreds of base of skull radiosurgeries using Cyberknife and Tomotherapy. Former Vice Chair of the national cooperative research group, the Radiation Therapy Oncology Group (now NRG-Oncology), as well as former chair of the Symptom Management Committee of the RTOG. Served as the Chair of the Quality of Life program of the annual American Society of Radiation Oncology (ASTRO) annual meeting. Editor of Dying and Death in Oncology, Springer. Mohammad Hassan Noureldine received his Medical Degree from the Lebanese American University (LAU) in 2016 and a master's degree in Neuroimaging from Lebanese University (LU) in 2018. He graduated in 2012 with a bachelor's degree in biology and minor in chemistry from LAU and received a University Diploma in clinical research in 2014 from LU. In 2018, he joined the Department of Neurosurgery at Johns Hopkins All Children's Hospital (JHACH) as a postdoctoral research fellow and currently completing a surgical internship at the University of South Florida.

Section I

Section II

Section III

Section IV

Section V

Section VI

Section VII



Olfactory groove:

Meningioma [Anterior fossa floor/Olfactory groove]
Esthesioneuroblastoma


Planum sphenoidale/Tuberculum sellae:

Meningioma [Tuberculum/Perioptic]


Sellar/Suprasellar:

Pituitary tumor [Nonfunctional, Cavernous sinus]
Pituitary tumor [Prolactinoma, Cavernous sinus]
Pituitary tumor [Acromegaly, Cavernous sinus]
Pituitary tumor [Cushing]
Pituitary tumor with chiasmal compression [Reduced dose SRS or hypofractionated]
Craniopharyngioma [Adult]
Craniopharyngioma [Child]
Metastasis to the Sella
Rathke's Cleft cyst [Recurrent]


Parasellar space/Cavernous sinus:

Oculomotor schwannoma
Trochlear schwannoma
Abducens schwannoma
Trigeminal schwannoma
Meningioma [Cavernous sinus, Small/Medium]
Meningioma [Cavernous sinus, Large, 5-session hypofractionated]


Clivus:

Chordoma [Clivus/Cavernous sinus]
Metastasis to Meckel's cave/Clivus bone
Solitary Fibrous Tumor [Clivus]


Cerebellopontine Angle

Meningioma [Petroclival with diplopia]
Meningioma [Petroclival with TGN, Tumor + Nerve dose plan]
Meningioma [Inferior petrous ridge]
Meningioma [Petrous ridge posterior to IAC]
Meningioma [Cerebellopontine angle]
Chondrosarcoma [Petrous ridge]
Endolymphatic sac tumor


Internal auditory canal:

Vestibular schwannoma [4mm, Intracanalicular]
Vestibular schwannoma [10mm, Lateral fundus]
Vestibular schwannoma [10mm, Medial canal]
Vestibular schwannoma [18mm]
Vestibular schwannoma [23mm]
Vestibular schwannoma [30mm]
Vestibular schwannoma [After prior resection]
Vestibular schwannoma [Poor hearing in the contralateral non-tumor ear]
Vestibular schwannoma [Neurofibromatosis type 2]
Facial schwannoma [Auditory canal]
Facial schwannoma [Geniculate]
Facial nerve hemangioma


Jugular foramen:

Jugular foramen schwannoma
Glomus tumor
Meningioma [Jugular foramen]


Foramen magnum:

Hypoglossal schwannoma
Meningioma [Foramen magnum]


Miscellaneous

Meningioma [Torcular]
Meningioma [Transverse sinus]
Meningioma [Grade 2 histology, Multiple sites]
Meningioma [Neurofibromatosis type 2, Skull base]
Hemangiopericytoma
Adenoid cystic carcinoma
Squamous Cell carcinoma [Head and neck with perineural spread]
Epidermoid cyst
Dural arteriovenous fistula [Transverse sinus]
Dural arteriovenous fistula [Cavernous sinus, Carotid-Cavernous fistula]