Our expert team is experienced in dealing with both common and rare skull base disorders, ensuring that patients with complex presentations receive expert and integrated care.
Quick access to leading diagnostics on-site
Expert support guiding your next steps
Our service is built around a tailored, four-stage clinical pathway, which provides specialist expertise from first contact through to treatment and follow-up. Patients are supported at each stage by senior clinicians and dedicated administrative and perioperative teams.
We begin with a comprehensive outpatient consultation, incorporating advanced diagnostic investigations. This detailed assessment involves high-resolution, cross sectional imaging, high-definition endoscopic evaluation and specialist pathology review. This structured work-up ensures diagnostic accuracy from the outset and allows us to formalise an individualised and effective treatment plan for each patient.
All cases are formally reviewed within a specialist MDT, bringing together expertise in skull base surgery, neurosurgery, radiology, oncology, pathology, and allied disciplines. For international patients, we also participate in cross-border MDT discussions on request, supporting continuity of care and maintaining close collaboration with referring clinicians. This comprehensive evaluation, with input from world-leading experts in their respective fields, ensures optimal treatment and continuity of care for our patients.
Definitive treatment is delivered at our specialist London facilities, where patients benefit from state-of-the-art surgical technology, experienced consultant teams and dedicated perioperative support. We offer both minimally invasive and open surgical approaches, selecting the most appropriate technique based on pathology, anatomy and individual patient needs and preferences.
We provide flexible follow-up arrangements to support optimal recovery and ongoing monitoring. Patients may be reviewed face-to-face in London as many times as necessary. Follow-up in a patient’s home country, via remote consultations, are available when clinically appropriate. Our patient’s report high satisfaction with our approach to post-treatment surveillance and high-quality continuity of care.
The Skull Base Specialists offer a comprehensive repertoire of techniques. The team are skilled in both open craniofacial and minimally invasive endoscopic surgical approaches. Treatment plans are tailored to each patient after careful MDT evaluation, balancing oncological safety, surgical access, and preservation of function. The Skull Base Specialists’ breadth of expertise allows us to select the best, evidence-based method for each individual case. Our practice incorporates advanced established and emerging technologies.
Transorbital Neuro‑Endoscopic Surgery (TONES) is a minimally invasive technique that allows our surgeons to reach certain areas of the skull base through a small incision around the eyelid. This approach avoids the need for larger openings in the skull, helping to reduce scarring, shorten recovery time, and protect surrounding structures.
We use TONES only when it is the safest and most effective option for a patient’s condition. It can be suitable for selected meningiomas, lesions near the orbital apex and carefully chosen conditions involving the cavernous sinus.
As a globally recognised centre in skull base surgery, our team will guide you through whether this approach is appropriate for you, ensuring every decision prioritises your safety, vision, and long‑term function.
We use a range of minimally invasive endoscopic endonasal procedures to treat conditions affecting the nose, sinuses and midline skull base. These techniques use natural corridors inside the nose to reach deep areas of the inner skull safely, avoiding external cuts and supporting a smoother recovery. Each approach is selected carefully to match the location of the condition and what is safest and most effective for you.
There are two parts to your treatment:
Our endoscopic techniques are used to manage a wide range of sinonasal and midline skull base conditions, offering precise treatment with minimal disruption to surrounding tissues:
To support the safest and most precise surgery possible, we habitually use state-of-the-art image-guided systems. These technologies act like a detailed map and real-time ‘sat nav’ for the surgeon, helping us navigate delicate areas of the skull base with exceptional accuracy. They allow us to plan your operation carefully, protect important structures and tailor every step to your individual anatomy. Our advanced tools include:
These technologies enhance our surgical expertise. By combining world-leading clinical skill with the most advanced tools available, we ensure every procedure is carried out with the highest level of precision, safety, and confidence.
Minimally invasive or ‘keyhole’ approaches are techniques to reach the skull base through the smallest possible openings. These approaches are designed to reduce disruption to surrounding tissues, shorten recovery time, and minimise scarring, while still allowing safe access to delicate areas of the brain, eye socket, and sinuses.
Minimally invasive techniques are used only when they offer the same or better safety and effectiveness as more traditional open surgery. Here are some examples of minimally invasive techniques that the Skull Base Specialists perform regularly
In skull base surgery, there isn’t just one minimally invasive route. Depending on where a tumour or problem sits, surgeons can sometimes use different small, carefully chosen pathways to reach it safely (called alternative minimally invasive corridors).
This means that the surgeon doesn’t go through standard endonasal (through the nose) approach but slod avoids a large opening in the skull. Instead, the surgeon may approach through the eyelid (transorbital), through the eyebrow (supraorbital keyhole), or other tiny openings which would leave minimal scarring.
Keyhole techniques are not used for every skull base condition. The Skull Base Specialists will recommend them only when they provide a clear benefit and when they allow us to treat the problem with the same level of precision and safety as open approaches. Our goal is always to choose the approach that offers the best outcome for you.
Microsurgical techniques use a specialised operating microscope to magnify the area being treated. This gives the surgeon a much clearer, more detailed view of nerves, blood vessels, and other important structures at the skull base. Because everything is magnified, the surgeon can work through smaller openings, handle tissues more gently, and avoid structures that are only millimetres apart.
Microsurgery is often used when a minimally invasive or keyhole approach is possible, but it is also part of many open skull base operations where precision is essential. The aim is always the same: to remove the problem safely while protecting normal function as much as possible.
While many skull base conditions can be treated through minimally invasive or keyhole routes, there are times when a more traditional open approach is the safest and most effective option.
Open surgery provides a wider view and greater access to complex areas, especially when a tumour is large, involves important nerves and blood vessels or extends into several parts of the skull base.
These operations may involve larger incisions; as such they are chosen only when they offer the best chance of complete, safe treatment. Our open craniofacial and neurosurgical approaches include:
For conditions affecting the side of the skull base and the ear, we offer specialist lateral approaches:
Across all open procedures, our focus remains the same: protect vital structures and support the best possible long-term outcome. Even in open surgery, we use modern microsurgical techniques and advanced imaging.
At London Skull Base Specialists you have access to world-class plastic surgeons who can perform and careful reconstruction. Read more on our reconstructive surgery page.
Reconstruction is an important part of skull base surgery. After removing a tumour, we use specialist plastic and reconstructive techniques to restore form, function and the patient’s natural appearance.
Our aim is always to protect vital structures, support healing and help patients return to normal life with confidence. Every reconstruction is tailored to the individual, using the safest and most effective method for their specific condition.
Skull base patients may hear their surgeons talk about a ‘flap’ as part of their reconstruction. A ‘flap’ is a section of healthy tissue, such as skin, muscle or fat – or a combination) that is moved to repair an area after surgery. Unlike a skin graft, a flap keeps its own blood supply, which helps it heal more predictably and makes it suitable for repairing deeper or more complex defects.
We offer a full range of reconstructive options, including:
For skull base–specific reconstruction, we use advanced techniques to ensure a safe, repair for the inner structures:
Across all reconstructive procedures, our focus is on safety, durability, and natural results. By combining specialist plastic surgery expertise with world-leading skull base techniques, we ensure every patient receives the most appropriate and effective reconstruction for their needs.
Some skull base conditions are caused by malignant (cancerous) tumours, and these may require treatment beyond surgery alone. Even certain benign tumours may need additional therapy if they sit in critical areas where further growth could cause harm. For these reasons, we work closely with a network of expert oncologists, radiologists and cancer specialists across our network of London hospitals – internationally renowned for their exceptional cancer care.
Your treatment plan is discussed within a multidisciplinary team (MDT) that brings together skull base surgeons, oncologists, radiologists, pathologists and specialist cancer nurses. This collaborative approach ensures that every aspect of your care — from diagnosis to long-term follow-up — is guided by the best available expertise.
Alongside surgery, patients may benefit from a range of advanced non-surgical treatments, including:
Through our partnerships with globally renowned London cancer centres, patients have access to the full spectrum of modern oncology care. This ensures that every patient receives a treatment plan tailored to their tumour type, location, and personal needs, delivered by specialists who work together seamlessly.
Although our team specialises in advanced skull base surgery, many patients also benefit from non-surgical treatments and support from a wider network of expert clinicians. Skull base conditions can affect hormones, vision, hearing, balance, facial movement, and overall wellbeing, so care involves more than surgery alone.
We work closely with leading specialists across London to ensure every patient receives comprehensive, coordinated care tailored to their individual needs.