The pursuit of a cholesteatoma by harvey cushing: staged approach to a complex skull base tumor.

Objective The evolution of neurosurgical techniques during Harvey Cushing's practice was immense. The authors illustrate this evolution using archived historical records from Harvey Cushing. Setting Historical patient records retained by the Cushing Center at Yale University Department of Neurosurgery. Design The authors present the case of one of Cushing's patients with a cholesteatoma. Results Cushing's surgical treatment of a cholesteatoma extending into the skull base is an example of his meticulous documentation and accelerated surgical techniques. Conclusions This case demonstrates how neurosurgical techniques advanced in the management of complex skull base tumors via a staged approach through the middle and posterior fossae at a time long before the development of modern skull base surgery.