Surgical partners successfully remove nearly 2,000 cranial base tumors

Apr 19 2017

In one of the nation's longest and most successful surgical partnerships, Loyola Medicine neurosurgeon Douglas Anderson, MD, and otologic surgeon John Leonetti, MD, have worked together to remove nearly 2,000 cranial base tumors during the past 30 years.

Drs. Leonetti and Anderson remove both benign and malignant tumors. The vast majority of their patients are disease-free after five years and experience little or no facial paralysis. Hearing is preserved whenever possible.

When a tumor is discovered at the undersurface of the brain, known as the cranial base, it requires careful planning and delicate surgery, often by teams of surgical specialists. Surgeons must remove as much of the cranial base tumor as possible, without damaging nerves that control functions such as hearing, facial movements and balance.

Drs. Anderson and Leonetti, co-directors of Loyola's Center for Cranial Base Surgery, collaborate on certain types of cranial base tumors that involve both of their areas of expertise. Dr. Leonetti gains access to the tumor and identifies the nerves that must be saved. He then removes the portion of the tumor that lies within the inner ear cylinder. Dr. Anderson removes the portion of the tumor that lies next to the brain.

Dr. Anderson is a professor and chair of Loyola Medicine's department of neurological surgery. Dr. Leonetti is a professor and vice chair of the department of otolaryngology. Their relationship goes back 34 years, when Dr. Anderson was a junior attending neurosurgeon at Loyola and Dr. Leonetti worked under him as a resident.

While Drs. Leonetti and Anderson each have their own practices, they also collaborate on cranial base tumors. They're good friends, enjoy working together and have great respect for one another. Dr. Anderson said Dr. Leonetti "is an excellent surgeon." Dr. Leonetti said Dr. Anderson "is technically the most gifted neurosurgeon I've ever seen. He's more like a brother than he is a partner."

About two-thirds of the cranial base tumors Drs. Anderson and Leonetti remove are acoustic neuromas. An acoustic neuroma, also known as a vestibular schwannoma, is rare, occurring in about 1 in 100,000 people per year. It is located in the inner ear and grows inward toward the brain. It's slow-growing and usually benign. The tumor can cause hearing loss in one ear and numbness on one side of the face. If the tumor grows large enough, it can be fatal.

Other tumors Drs. Leonetti and Anderson remove include chondromas, chondrosarcomas, chordomas, epidermoid tumors, glomus tumors, lower cranial neuromas, meningiomas, squamous cell carcinomas and temporal bone cancers.

Fifteen surgeons at Loyola's Center for Cranial Base Surgery treat patients with these and other tumors at the undersurface of the brain, an area that borders on the brain, ears, eyes, nose, throat and neck.

Loyola's neurosurgeons, otolaryngologists and other specialists each bring unique expertise to treat cranial base tumors, which often surround the nerves and blood vessels traveling to or from the underside of the brain. The center has developed innovative methods for the safe and complete removal of difficult-to-reach cranial base tumors and lesions that might otherwise be considered inoperable.

Loyola strives to coordinate diagnosis, surgery techniques and other therapies to achieve the best possible outcomes. Treatment options include state-of-the-art neuroradiology, lasers and intraoperative microscopic techniques, endoscopic skull base surgery and stereotactic radiotherapy.