Glasgow Skull Base Fellowship

Based at: NHS Greater Glasgow and Clyde

Surgical Specialty Association approving: RCS England

Approval period: February 2023–January 2026

Supervisor/Lead Consultant: Mr William Taylor, Consultant Neurosurgeon at the Institute of Neurological Sciences Glasgow; Co-Supervisors are Consultant Neurosurgeons Mr Parameswaram Bhatthathiri and Mr Samih Hassan

Fellowship duration: 12 months

Stated learning outcomes:

Knowledge and understanding

  • To develop a holistic management strategy for patients with pituitary and skull base disorders.
  • To progress their understanding of skull base anatomy, the natural history of lesions and their management, while participating in all aspects of sub-specialist patient care.
  • To produce an original piece of research aligned with the progression in treating skull base disease.

Practical (Clinical and Technical) Skills

  • To develop robust ability in skull base surgical approaches (both endoscopic and open) and in the pre-operative evaluation and peri-operative management of patients with skull base disorders, including endocrine disturbance.
  • The ability to manage common complications of skull base surgery e.g. CSF leak.
  • To attend SRT MDT meetings and therapy sessions to develop an understanding of oncological treatment options for skull base pathology.

Personal and professional skills

  • To be able to meaningfully contribute within sub-specialty MDTs.
  • To collaborate in a collegiate manner with associated specialties in ENT, OMFS, endocrinology and oncology.
  • The ability to evaluate all treatment options and communicate these clearly and effectively to patients to encourage autonomous decision making.

Clinical competencies to be achieved:

  • Publish an original piece of research.
  • Organise the annual Clinico-Pathological Conference on Pituitary Disease.
  • Ability to perform the trans-sphenoidal endoscopic approach for the pituitary disease.
  • Ability to perform the endoscopic approach for lesions of the anterior skull base.
  • Familiarity with rhinological techniques for skull base reconstruction.
  • Trans-cranial surgical approach for the pathology of the cerebropontine angle e.g. vestibular schwannoma.
  • The clinical assessment includes providing informed consent for patients attending sub-speciality outpatient clinics.
  • The ability to manage peri-operative complications of pituitary surgery.
  • The ability to manage common complications of skull base surgery e.g. CSF leak.

The number of main operations the fellow could expect to be involved in:

Approximately 150 cases per year (excluding emergency surgeries):

  • 60 to 80 Trans-sphenoidal operations (performed 10-30), of which:
  • 15 to 20 Extended trans-sphenoidal operations. (performed 1-5)
  • 10 to 20 Craniotomies for suprasellar tumour. (performed 5-10)
  • 6 to 8 transcranial/labrynthine approaches for vestibular schwannoma (performed 1-3)
  • 6 to 10 posterior fossa transcranial approaches for skull base tumours e.g. meningioma (performed 3-5)
  • 4 to 6 paediatric transphenoidal/skull base approaches for tumour. (performed 0-1)