The Skull Base Surgery program at the University of Colorado is dedicated to providing exceptional training and experience in the performance of complex intracranial neurosurgery with an emphasis upon the application of skull base surgical techniques to ordinary and extraordinary tumors and vascular lesions. The fellows and residents participate in an intense training to become an integral member of a multi-disciplinary team that incorporates the expertise of Otolaryngology, Head and Neck Surgery, Oculoplastic Surgery, Plastic Reconstructive Surgery, Neuro-Oncology, Radiation Oncology and Neuroradiology. In addition to gaining sufficient clinical experience to begin independent practice and form a skull base surgical clinical division, the trainees perform sufficient research, publications and presentations to begin an academic career. Cranial and skull base endoscopic approaches are a relatively new field in complex cranial surgery. Currently, full endoscopic training and teaching is integrated into the skull base microsurgical training in order to develop excellence in cranial endoscopy and minimally invasive complex cranial surgery.
I. Program Site
II. Program Integration
The Endoscopic/Skull Base Surgery training is provided by the University Of Colorado Department Of Neurosurgery, which is an ACGME accredited program. The program is fully integrated with the residency-training program, and activities are coordinated to enhance the trainees’ education and experience. The residents/fellows practice complex skull base approaches on specially prepared cadaver specimens for that purpose. Research projects focused on studying microsurgical anatomy and modifying/refining skull base approaches are assigned to the trainees. Residents/fellows are expected to be involved in research projects and publications every year. At the clinical level, the intense exposure in the lab will promote the residents/fellows’ surgical skills in the operating room. This is the ultimate practical goal to help young neurosurgeons deal with the type of complex cranial cases they encounter at the University of Colorado Hospital.
III. The Residents Simulation Course
An annual intense microdissection simulation course is given to the residents/fellows. The hands on part of the Skull Base Surgery Course is once a week for 6 weeks beginning in July and ending in August of each year.
The two 3rd year residents and the fellows are the primary participants in the course that includes all the residents on the clinical neurosurgery service.
IV. Clinical Fellowship Program
Curriculum for Skull Base Surgery Fellowship:
1. Participation in operative cases three days per week at UCH. Participation in occasional cases at other centers including the Children’s Hospital and Denver Health Hospital according to clinical need.
2. Participation in management of hospitalized patients critical and non-critical care.
3. Attendance in the Skull Base Surgery Clinic one day per week.
4. Participation one day per week in the CSI Microsurgery Laboratory for cadaveric investigation and preparation of lectures and manuscripts.
5. Attendance at the academic programs of the University of Colorado Department of Neurosurgery (Morbidity and Mortality Conference and Grand Rounds).
6. Prepare and present Grand Rounds presentation to the faculty and residents at Department of Neurosurgery semiannually .
7. Participation in the weekly multi-disciplinary Tumor Board.
8. Participation in the bimonthly multi-disciplinary Skull Base Surgery board.
9. Participation as faculty for practical courses at the annual meetings of the AANS/CNS.
10. Participation as faculty for practical courses at the CSI Microsurgery Laboratory.
11. Attendance at the weekly program review meeting to assess progress of research and clinical projects.
The research component of the Skull Base Surgery fellowship year is both clinical and basic. Basic research focuses on development of innovative surgical approaches or refinement of existing approaches supported by cadaveric dissection in the CSI Microsurgery Laboratory. Analysis and publication of clinical cases and series is also a mandatory component of the research program, which runs concurrently with the clinical program. In preparation for an academic career, preparation and publication of peer reviewed and solicited writings are mandatory. Grant submission is encouraged but optional.
The Skull Base Surgery fellow will be evaluated semiannually by the directors of the Skull Base Surgery Program with input from members of the faculty representing neurosurgery as well as the other departments that comprise the multi-disciplinary Skull Base Surgery team.
The Skull Base Surgery fellowship is designed to prepare the fellow for an academic career. The fellows will develop and deliver presentations on skull base related topics for local, national and international neurosurgical audiences. The fellows will demonstrate skull base surgical techniques to neurosurgeons at all levels of training using the CSI Microsurgery Laboratory locally and the mobile laboratory at the annual meetings of the national neurosurgical organizations (AANS, CNS). The fellows will serve as faculty for the national practical courses given annually for senior residents.
Mohammed Aref, MD
Jacob Freeman, MD
University of Colorado School of Medicine
Raghuram Sampath, MD
Saint Louis University
Steven Carr, MD
University of Colorado School of Medicine
University of Minnesota
A national 3-day cadaveric dissection-training course in Skull Base/Endoscopic Surgical Techniques is held in the CSI Laboratory, University of Colorado Anschutz Medical Campus . This is invitational course taught by world-class experts in skull base and cranial endoscopy to senior residents teams combining Neurosurgery and Otolaryngology. This course offers an intensive review of the technical nuances involved with skull base procedures including comprehensive 3-D anatomy and 3-D surgical video presentations. Participants will receive didactics and hands on instructions on traditional skull base approaches and endonasal and transcranial endoscopy including indications, techniques, outcomes complications avoidance and management.