Imperial Skull Base Fellowship, London

Based at: Imperial College Healthcare NHS Trust 

Surgical Specialty Association approving: RCS England

Approval period: First approved January 2018; reapproved June 2021May 2024

Supervisor/Lead Consultant: Mr Nigel Mendoza, Consultant Neurosurgeon, with Mr Ramesh Nair, Consultant Neurosurgeon

Fellowship duration: 12 months

Stated learning outcomes:

  • The Fellowship provides advanced training in the diagnosis and optimal management of patients with cranial base disorders as well as preparation for future leadership in the field of skull base surgery.
  • To give Fellows the opportunity to master skull base surgical approaches, expert evaluation and perioperative management of patients with skull base disorders.
  • Fellows will acquire an in-depth knowledge of skull base anatomy, lesions, and their management while participating in the evaluation, operation, and follow-up care of all patients in the service.

Clinical competencies to be achieved:

  • Transphenoidal procedures for Pituitary tumour
  • Endoscopic approaches to lesions of the anterior skull base
  • Posterior Fossa Craniectomy for Microvascular decompression
  • Surgical treatment of CPA lesions eg Acoustic Neuroma
  • Clinical assessment of patients with skull base pathology in general and specialised outpatient clinics, including the ability to obtain informed consent

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

6 months (with the potential to extend to 12 months):

  • Transsphenoidal resection of tumour/cyst – 10 to 20
  • Expanded endonasal approach (meningioma/chordoma/etc) – 2 to 5
  • Vestibular schwannoma – 1 to 3
  • Anterior circulation aneurysm clipping – 1 to 5
  • Skull base meningioma/tumour – 1 to 5
  • Microvascular decompression – 1 to 3
  • Percutaneous trigeminal rhizotomy – 5 to 10
  • Foramen magnum decompression – 1 to 2

Fellows awarded Fellowship Certificate (dates of Fellowship):

  • Rob Iorga (Feb 2018 - Aug 2018)
  • Iwan Bennett (Aug 2018 - Aug 2019)
  • Arthur Dalton (Sept 2019 - Feb 2021)
  • Anna Oviedova (Feb 2022 - Jul 2023)