The skull base unit in Manchester is one of the biggest in the country, and consists of a team dedicated to giving the highest possible standard of care to a group of patients with challenging conditions and complex needs. We deal with a wide range of problems occurring at the base of the skull, the most common of which are benign tumours such as vestibular schwannomas (acoustic neuromas) and meningiomas.
The cornerstone of this service is a fortnightly multidisciplinary team (MDT) meeting which was initially established in September 2009. This receives referrals from the local neuroscience unit, from a variety of clinicians and specialties across the Greater Manchester region, as well as from a wider referral base across the UK and from abroad based on our longstanding reputation. The multi-disciplinary team consists of skull base surgeons, oncologists, radiologists and nurses, allowing all management options to be discussed including surveillance, surgery or radiotherapy. Our patients are seldom discharged, but our MDT provides a reliable system of managing a large number of patients under long-term observation for their skull base tumours.
The treatment that is delivered for skull base tumours will either be surgery or radiotherapy, and we undertake a considerable number of each of these treatments each year. For those patients requiring surgery, we have a dedicated team of neuro-anaesthetists, theatre staff and ward nursing staff who have great expertise in dealing with these cases (we perform more than 140 skull base operations each year). Surgical techniques include open operations as well as endoscopic surgery.
We are also uniquely placed to offer training in this subspecialty field, and we have run both neurosurgical and ENT skull base fellowships longer than any other unit in the UK. Our fellows have gone on to establish successful skull base practices of their own all over the UK and the world.
The skull base team are also leaders in research, innovation and audit. Our work is regularly published and presented at national and international meetings, and we have played a key role in the establishment of national audits of practice. We believe strongly in scrutiny of practice and transparency of results, which allows us to offer thoughtful and evidence-based advice to our patients.