Oxford Skull Base Fellowship

Based at: Oxford University Hospitals NHS Foundation Trust

Supervisor/Lead Consultant: Mr Sanjeeva Jeyaretna Consultant Neurosurgeon

Fellowship duration: 12 months

This fellowship focuses on open and endoscopic surgery of complex skull pathology. There is a strong emphasis on building microsurgical skills and providing a foundation in all skull base approaches. There is the opportunity to be involved in the active Oxford Skull Base research programme.

Stated learning outcomes:

  • Safely perform retrosigmoid craniotomy and resect skull base pathology e.g. vestibular schwannoma, meningioma, epidermoid.
  • Safely perform far lateral approach for and resect skull base pathology e.g. meningioma.
  • Have a working understanding of pre-sigmoid approaches and be able to deliver combined ENT/Neurosurgical procedures to resect skull base pathology e.g. translab approach to vestibular schwannoma, combined petrosectomy to resect petroclival meningiomas.
  • Perform pterional craniotomy, subfascial approach and clinoidectomy to resect skull base pathology e.g. sphenoid wing, clinoidal meningiomas and anterior cranial fossa meningiomas.
  • Safely perform bifrontal craniotomy and resect skull base pathology e.g. anterior cranial fossa meningiomas.
  • Perform middle fossa approaches such as anterior petrosectomy and subtemporal approach for skull base pathology e.g. petroclival meningiomas, cholesterol granulomas, epidermoid.
  • Be proficient in expanded endonasal approaches for skull base pathology e.g. chordoma, chondrosarcoma, tuberculum sellae meningiomas, planum sphenoidale meningiomas, olfactory neuroblastoma.
  • Experience of other advanced skull base approaches e.g. infratemporal fossa approach and transorbital approach.
  • Be able to deal with the complications of skullbase surgery including CSF leak repair.
  • Be able to make appropriate decisions and discuss patients in the skull base MDT.
  • Be able to set up the operating theatre without assistance including positioning, neuronavigation, facial nerve and lower cranial nerve monitoring and endoscopy.

Clinical competencies to be achieved:

  • Safely resect a vestibular schwannoma without significant assistance.
  • Safely resect range the full spectrum of anterior and middle fossa meningiomas without significant assistance.
  • Build the fundamental skills foe complex posterior fossa pathology such as petroclival meningiomas
  • Be familiar with the complications and limitations of open anterior/lateral and expanded endoscopic skullbase surgery.

 

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

150 complex cases / year

Previous fellows have been able to perform 20 retrosigmoid craniotomies to resect vestibular schwannomas.

Over 90 complex meningioma operations. Fellows should expect to be competent in all complex skull base approaches including clinoidectomies, far lateral approach and anterior petrosectomy.

Fellows awarded Fellowship Certificate (dates of Fellowship):

  • Amr Mohamed (2017-2018)
  • Rob Iorga (2018-2019)
  • Gulam Zilani (2019-2020)
  • Prabu Rau Sririam (2020-2021)
  • Anouk Borg (2021-2022)
  • Alex Boukas (2022 - 2023)
  • Giannis Sokratous (2023 - 2024)
  • Ronald Tan (2024 - 2025)
  • Ashan Jayasekera (2024 – 2025)