It gives me great pleasure to welcome you to this meeting of the World Federation of Skull Base Societies, jointly hosted by the European Skull Base Society, and the British Skull Base Society. Once considered a novelty of dubious value, Skull Base Surgery is now a mature medical discipline practiced worldwide, even in developing countries. Thousands of patients with various neoplastic and vascular skull base pathologies have been helped by this discipline. This unique field has made previously inoperable lesions amenable to treatment. Importantly, as the field has matured, outcomes have improved dramatically.
When I was a neurosurgery resident over 25 years ago, we did see many patients with skull base pathologies but were stumped by many of the problems that seemed impenetrable at that time. Advances in the field during the last 20 years are due to the tireless efforts of many surgeons and physicians around the world. These advances have come about through a better understanding of skull base anatomy, remarkable innovation in developing new operations through the imagination of brilliant minds, collaboration between surgeons from different disciplines, and with physicians from non surgical disciplines, and the willingness of our patients to be part of this progress, which is sometimes beset with complications.
The sharing of information between centers, education of young surgeons through seminars, practical courses, and didactic training offered through fellowships are all very important means of making these advances in skull base surgery available to the world community at large. Formation of various National Skull Base societies, and the World Federation of Skull Base Societies has been critical in this regard. The meetings of these societies need to be exciting, and remain focused on sharing honest and real time information about outcomes of various treatment modalities, and recent advances. To advance our field, we need vigorous debate about the merits and demerits of various treatments, and the organizers of this meeting have provided the milieu for just that. In addition, social contacts between participants outside our scientific sessions are equally important to develop friendships and promote information sharing.
Skull base surgery as a whole still remains focused on its technical aspects, the current rage being endoscopic surgery. While this is always important for a predominantly surgical organization, we need to hear more about basic science advances which can be applied to our patients. The next paradigm shifts in treatment will come from less invasive approaches which involve the delivery of intratumoral antibodies, manipulation of genes, or intratumoral delivery of radiation.
Skull base surgery is a topical and very exciting specialty for young people from various disciplines to pursue. However, there is no substitute for hard work and for learning both the nuances and complication avoidance from the masters who have been there before. As the field expands, the World Federation will have an ongoing and critical role both in maintaining scientific rigor and in keeping this excitement alive.
Laligam N. Sekhar, MD, FACS
President, World Federation of Skull Base Societies
Professor and Vice Chairman
Director of Cerebrovascular and Skull Base Surgery
Department of Neurosurgery
Harborview Medical Center
University of Washington