Leeds Anterior Skull Base Endoscopic Fellowship

Based at: Leeds Teaching Hospitals NHS Trust

Surgical Specialty Association approving: RCS England

Approval period: Initially approved December 2015; reapproved June 2019–August 2022; reapproved June 2023–May 2026

Supervisor/Lead Consultant: Mr Nicholas Phillips, Consultant Neurosurgeon

Fellowship duration: 12–24 months

Stated learning outcomes:

At the end of the Fellowship ability to endonasally approach the Sella and contents safely, acting independently.
Able to understand basic rhinology techniques and rhinological anatomy.
Understand the endocrine management of patients with Pituitary dysfunction.
Have knowledge of the breadth and extent of endoscopic approaches to the skull base, in anatomical and pathological aspects.
Have the ability to choose the best intervention from a range for skull base pathology.

Clinical competencies to be achieved:

To provide a safe, comprehensive management plan for the investigation, operative management, and non-operative management of patients with pituitary disease.
To have a thorough understanding of the possible postoperative pituitary endocrine emergencies and their management.
To have a thorough understanding of the range of interventions available for the pituitary disease.

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

Supervisor: “This is complex surgery in an evolving field and not high-volume surgery. Trainees will have variable exposure to endoscopic surgery and many of them will not have done any endoscopic work of this nature throughout their eight years of run-through training. The speed with which they take up this new technique is very variable across trainees – some take to it like a duck to water, and others are only just getting the hang of the endoscope by the end of the year. They will all be exposed and be involved in, and contribute operatively to over 100 cases (ie every case we do). As regards independent operation, we would hope that they could achieve independence at the end of the year, but not everyone can. Some will have done 10–20 cases independently. They nonetheless have a very thorough grounding in all aspects of endoscopic surgery including patient assessment and review, dealing with complications, the full breadth of surgical difficulties from simple to very complex.”

Endoscopic endonasal surgery for pituitary adenoma, craniopharyngioma and meningioma: Total: 15; Performed: 3
Endoscopic endonasal surgery for Chordoma and Chondrosarcoma: Total: 3; Performed: 1
Endoscopic endonasal surgery for CSS leak, encephalocele and frontal sinus abnormalities: Total: 5; Performed: 2
Endoscopic endonasal surgery for rarer tumours invading the skull base such as olfactory neuroblastoma: Total: 3; Performed: 0-1
Combined open-endoscopic operations for extensive, invasive tumours: Total: 3; Performed 0-1

Fellows awarded Fellowship Certificate (dates of Fellowship):

Asim Sheikh (Aug 2017 - Aug 2018)
Basel Alromhain (Aug 2018 - Aug 2019)
Mark Hughes (Sep 2019 - Oct 2020)
Dhruv Parikh (Nov 2020 - Sep 2021)
Salman Shaikh (Sep 2021 - Aug 2022)