With the development of society and science and technology, people’s thinking pattern has also changed tremendously. At present, people-oriented, improving patients’ quality of life and reducing medical costs have become the goals pursued by doctors. From the previous single means of treatment, the pursuit of large, fast and complete tumor removal by surgery has changed to multiple means and joint treatment by multiple disciplines. Minimally invasive surgery is used to reduce complications, decrease disability rate, improve patient’s survival quality and solve patient’s pain as the goal of treatment. Instead of one-sidedly pursuing complete resection of tumor, radiotherapy and chemotherapy should be given selectively according to the patient’s age and physical condition. Therefore, the choice of treatment and surgical approach should be based on the operator’s good surgical approach and technique, the patient’s general condition, the family’s economic status, the patient’s and family’s psychological state and any special requirements, etc. The personalized choice of treatment plan has become the responsibility of the current social physicians. Material basis of personalized treatment 1. Individual differences Different races, ages, genders, occupations, tumor incidence and sites are different, and there are differences in tolerance, sensitivity, treatment and prognosis of treatment. There are individual differences among different tumors, i.e. tumor heterogeneity, including genetic heterogeneity, functional heterogeneity, anatomical heterogeneity, spatial heterogeneity and temporal heterogeneity. Genetic heterogeneity refers to the molecular pathology of tumors to elucidate the nature of tumors and to speculate on their prognosis. Some indicators, including O6-methylguanine-DNA methyltransferase (MGMT) and epidermal growth factor receptor (EGFR), can reveal the biological characteristics of tumors. Functional heterogeneity is in turn closely related to the biological characteristics of tumors. Different tumors have different biological activities, i.e., different clinical manifestations, different modes of destruction, invasion or extrusion of surrounding structures, and different therapeutic management and prognosis, for example, the aggressiveness of pituitary adenomas is associated with high expression of CD147, Galectin-3 (gal-3) and microvascular density (MVD). Anatomic heterogeneity refers to the fact that tumors are often found in specific anatomic sites, such as meningiomas, which are found in the dura mater of the central region of the skull base; chordomas, which are found in the slope region; pituitary adenomas and craniopharyngiomas, which are found in the saddle region; trigeminal fibromas, which are found in the plexus and hemimelia structures in front of the hemimelia; chondrosarcomas and osteochondromas, which are found in the skull base and disrupt the skull base to develop intracranially and extracranially; and cavernous hemangiomas, which are confined to the paracranial space on one side. The spatial heterogeneity refers to the fact that different geographical areas and regions are affected by the disease. Spatial heterogeneity refers to the incidence of tumors in different geographic areas and races, and the types of tumor development, which do not have exactly the same response to the same treatment. Temporal heterogeneity refers to the fact that the proliferation cycle of tumor cells has its own characteristics, and the same tumor may not be the same. Due to the different biogenic characteristics of tumors, the choice of treatment strategy should also be emphasized. Rational selection of skull base tumor treatment The treatment of skull base tumor should be selected based on the comprehensive factors such as disease, systemic condition and family requirements, including surgical resection, radiotherapy, chemotherapy, herbal medicine and immunotherapy. It is not the case that surgery is needed immediately after the diagnosis of tumor, nor is it the case that radiotherapy and chemotherapy are given directly without considering the side effects, nor is it the case that fear of active treatment will bring new complications or side effects and go to the other extreme and give up the treatment for the one-sided pursuit of safety. Taking pituitary adenoma as an example, bromocriptine treatment is preferred for prolactin adenoma regardless of macroadenoma or giant adenoma. Through a period of treatment, not only the tumor volume can be reduced, but also the PRL level can be significantly decreased. When PRL levels remain normal for at least two years, the tumor volume can be reduced by more than 50. However, discontinuation of treatment can lead to an increase in tumor volume and recurrence of hyperprolactinemia, so close follow-up is necessary when treating patients with prolactin adenomas with medication, such as after drug reduction or discontinuation. Germ cell tumors in the pineal region, due to the complexity of its anatomical location, which is adjacent to the midbrain and important large vessels such as the internal cerebral vein, basilic vein, and large cerebral veins, are more risky for craniotomy, have higher disability and mortality rates, and are prone to subarachnoid dissemination, but are sensitive to radiation therapy, and therefore need to be treated with whole-brain radiotherapy and chemotherapy along with targeted radiotherapy. With the rapid development of microsurgical techniques, the application of intraoperative neurophysiological monitoring and the continuous improvement of postoperative care, the total resection rate of tumor is as high as 98, and the postoperative preservation rate of facial nerve, trigeminal nerve and cochlear nerve is significantly improved. Pollock reported the results of treatment of 87 cases of unilateral auditory neuroma, and divided the patients into surgical and gamma knife groups. 40 of them were treated with microsurgery and 47 with gamma knife, and it was found that the incidence of delayed facial nerve disorders after the treatment was between Thus, although microsurgery remains the treatment of choice for auditory neuroma, Gamma Knife is another effective treatment for small auditory neuroma because of its effectiveness in preserving the function of the auditory, facial, and trigeminal nerves and the relatively high rate of tumor growth control demonstrated by long-term follow-up. Therefore, the treatment of skull base tumors should be individualized and designed to select a treatment method that is most suitable for the patient according to the biological characteristics, size, location, growth pattern, blood supply, imaging features and the requirements of the family and the patient.