Skull base surgeries are performed in the area toward the base or bottom of the skull. Surgeries in this area may be performed for both cancerous and non-cancerous growths and also for abnormalities on the underside of the brain and skull base.
To operate endoscopically, the surgeon inserts the instruments through the natural openings of the head like the nose or mouth. This type of surgery may require a specialist team of surgeons including ENT surgeons, neurosurgeons and radiologists.
Ailments that require Skull Base surgery
This is a limited list of some of the more common ailments and diseases that require intervention with Skull Base surgery.
- Lateral skull base
- Vestibular schwannoma
- Paragangliomas (Glomus tumours)
- Malignant Otitis Externa
- Meningioma: Non-cancerous tumours that can be found in the tissue between the skull and the brain.
- Neurovascular Trigeminal Neuralgia: Intense pain lateralized to one side of the face.
- Facial myoclonus: Constant twitching of facial muscles
- Anterior skull base
- CSF leak repair
- Meningoencephalocele
- Pituitary tumors
- Orbital tumors
It is important to note that this list is limited, and other ailments require Skull Base Surgery.
Why might I need Skull Base Surgery?
Symptoms do not necessarily present themselves in the same way across patients but vary depending on the individual case, type, size as well as location of the deformity or growth in the skull. However, some generalized symptoms include, but are not limited to:
- Headache
- Facial Pain
- Visual Problems
- Numbness
- Dizziness
- Weakness in the face
- Nasal Congestion
- Tinnitus (Ringing in the ears) or Hearing Loss
- Frequent Sinus Infections
How is my ailment diagnosed?
The diagnosis of these abnormalities or growths is based on the presenting symptoms and a physical examination. However, due to the location of the disease, defect or abnormality, it cannot be seen directly during a physical examination. Hence, for an accurate diagnosis, certain imaging studies (radiological scans) are informative.
- Brain Imaging Studies- These include:
- MRI (Magnetic Resonance Imaging)
- PET (Positron Emission Tomography)
- CT (Computed Tomography)
- MRA (Magnetic Resonance Angiogram)
These allow the doctors to assess the extent of the disease.
- Biopsy- This is where a small tissue sample is taken out from the lesion and sent for a histopathological examination.
- Other Tests: Hearing, vision and cranial nerves may be checked. Scans or studies of other parts of the body may also be required.
Types of Skull Base surgery
There are two main ways of performing skull base surgeries, endoscopic or minimally invasive surgery and traditional or open skull base surgery. The endoscopic surgery technique is preferred, however, there may be times when the traditional approach may be the only option.
- Endoscopic Skull Base Surgery (Minimally Invasive)- The benefit is that this surgery does not require a large incision. The incision may be made inside the nose allowing the surgeon to insert the endoscope and operate. Previously done imaging studies like the CT Scan and MRI help the surgeon during surgery.
- Open Skull Base Surgery- This surgery may require facial incisions. Part of the bone may also need to be removed so that the surgeon can reach the growth and operate.
Post-Operative Care for Skull Base Surgical patients
Post-operatively, the patient is closely monitored to make sure a smooth recovery. The end goal is for the patient to return to their normal life. Some patients may need repeated follow-ups and radiological scans to ensure the growth does not return. Due to the stressful nature of this surgery, a patient needs support from their families and friends.