Skull base surgery with Raymond Cho, MD | Ohio State Medical Center

The Ohio State University Wexner Medical
Center has one of the top skull base programs in the country. Skull
base surgery is basically surgery that involves any disease or tumor that
that involves the base of the skull, which in many cases also involves the orbit or the eye socket. All skull base teams have a neurosurgeon and an
ear, nose and throat doctor that are involved, but not every skull base team
in the country has an orbital specialist that’s dedicated to that skull base
team. I have the privilege of being the orbital specialist for the OSU skull
base team and in that capacity I’m able to lend my expertise to a lot of those
processes that can affect the orbit directly or the optic nerve, which is
deeper back into the cranial cavity and can cause vision loss. And so in that
way, I can use my expertise as both an ophthalmologist and an orbital surgeon
to produce the best outcomes possible for our patients. One example of the
value that I can bring to the skull base team is that sometimes there are tumors
that are in the brain in what we call the middle cranial fossa
that are right behind the eye socket. And normally, these tumors would be
approached by a neurosurgeon by doing a craniotomy. That’s where we make a
large scalp incision, we remove a part of the skull and then the neurosurgeons
approach the tumor through that route. Here at Ohio State though we’ve had the
opportunity on several occasions to actually instead of doing a large
craniotomy we’ve been able to go through the eye socket because of how close it
is to the back of the eye socket. I can make a small incision about this long
through the eyelid, temporarily remove the bone in the back of the eye
socket and then the neurosurgeons can go through that approach and deal with that
tumor instead of having to do a large craniotomy. And that can greatly decrease the risk
to the patients and also provide them a better aesthetic result from the surgery.
So one of the advantages of having oculoplastic surgery as a specialty at
The Ohio State University is that we have the expertise to do orbital
surgery in a safe manner and we can pretty much remove just about any tumor
that needs to be removed safely through what’s known as an anterior approach,
through the front of the eye. Sometimes, however, we need to take
different approaches for certain types of tumors. Sometimes we go through the
nose and go through the floor or the medial wall of the eye socket, the wall
that’s next to the nose. Sometimes, in rare cases, we have to actually get
neurosurgery involved and do a craniotomy where we remove part of the
skull in order to get to the orbit. The thing about Ohio State is that we have
one of the top skull base surgery teams in the country and as a member myself, as a member of the skull base team, I’m able to take advantage of their expertise
in order to deal with some of those very complex cases.

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