Top Experts Driving Skull Base Care Forward

The Cincinnati Children’s skull base surgery program was named a Multidisciplinary Team of Distinction by the North American Skull Base Society (NASBS), a neurological organization working to improve outcomes for patients with skull base pathology.

This honor recognizes medical centers that have notable experts from different specialties who diagnose, treat and manage skull base conditions. As a leading institution for research and treatment, Cincinnati Children’s is one of few health systems with specialists trained in pediatric care for pathologies of the skull base.

Skull Base Team of Pediatric Experts

This recognition confirms the breadth and depth of the specialized pediatric expertise at Cincinnati Children’s. Team members earning this designation include:

• Michael DeMarcantonio, MD
• Aaron Mochizuki, DO
• Brian Pan, MD
• Smruti Patel, MD

“We’ve built a great level of trust and respect for one another. We collaborate on the best approach for each patient,” explains Dr. Patel. “On complex cases, we think outside the box, discussing ideas and relying on each other’s expertise.”

Dr. Pan agrees that teamwork is key to the team’s success. “These cases require the talents of multiple subspecialists, in our case neurosurgery, ENT and plastic surgery,” he says. “That’s the real value of our work: combining expertise, technical abilities and experience. Otolaryngological surgeon Alessandro de Alarcon and neurosurgeon Jesse Skoch have built strong and capable teams at Cincinnati Children’s.”

Having this high level of care coordination provides an invaluable service to patients, in addition to improving outcomes.

“Our experience and the literature show that children have a different set of pathologies compared to adults,” says Dr. DeMarcantonio. “ENT and neurosurgical care are critical, but so is expertise in post-operative intensive care. These patients require all those resources working together. Our PICU—one of the best in the world—is an important resource for our patients.”

“Having multiple neurosurgeons and ENTs allows us to handle more cases and acute patients,” he continues. “Without all of us, we couldn’t do it.”

Coordination Among Highly Skilled Experts

Dr. Patel explains how critical teamwork is to the skull base program. “Skull base surgery requires collaboration, not just among surgeons, but also among our non-surgical colleagues. They also are critical in helping us manage both pre- and post-operative issues that can occur with patients.”

Treating brain tumors and other skull base disorders is extremely challenging because often they are hard to reach and entangled in the brain stem. Accessing and navigating such a small area requires careful precision.

“A health system really can’t do modern skull base surgery without a team of at least an ENT and neurosurgeon,” says Dr. DeMarcantonio. “The pituitary gland seems so close, but it’s difficult to reach safely.”

In the past, intracranial nasal dermoids (tumors that extend from outside the nose into the brain) were treated with a craniotomy. Now, thanks to collaboration, an endoscopic approach allows the intracranial portion of the tumor to be removed.

“Plastic surgeons are critical in figuring out how to enter the space and how to reconstruct that space afterward so we give the patient the best cosmetic outcome,” Dr. Patel says.

Unique Approaches Lead to Improved Outcomes

Surgical strategy and outcome goals differ for each patient. The team discusses whether a transnasal minimally invasive approach is best, for example, when removing a tumor.

“We’ve seen real growth in treating these rare tumors,” says Dr. DeMarcantonio. “We can avoid an open craniotomy for these children, and they don’t have a recurrence. It’s a real win and can only occur with all three groups working together.”

Recent advancements in equipment and surgical tools allow the team to do more minimally invasive surgeries.

“We address the functional and pathology issues, and also aesthetics and the overall form that can be a problem for these children over the long run,” says Dr. Pan. “Success is addressing pathology as well as ensuring that, in the future, the child’s nasal form is as normal as can be.”

Advancing Care Through NASBS

Cincinnati Children’s skull base work is impacting neurosurgical care in pediatrics worldwide. Through NASBS membership, the team engages in research, scholarly activity and clinical innovation.

“NASBS helps us stay informed about new advances in technology,” shares Dr. Patel. “Through conferences and clinical trials, we’re more involved, especially on the pediatric side since pediatric skull base teams are few and far between. In pediatrics, we care for a patient throughout their lifetime. There are unique things in the pediatric population that only those who provide pediatric care can speak to.”

NASBS allows the Cincinnati Children’s team to share success stories and their approach to uniquely complex cases through case presentations and reports. It also allows the team at Cincinnati Children’s to stay abreast of new techniques and collaborate with other experts in the country who also perform these procedures and treat skull base pathologies.

“It’s a privilege to work with such talented people at Cincinnati Children’s,” says Dr. Pan. “When you combine different thought processes and experiences, you optimize outcomes for kids.”

NASBS Disclaimer: Multidisciplinary Team of Distinction is based on meeting NASBS membership criteria and may not be construed as a medical referral.

(Published December 2025)

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