Skull base surgery


The undersurface of the brain is supported by a part of the skull called skull base. Many vital structures like the roof of the eye socket and the roof of the nasal cavity form a common wall with the skull base. The roof of many of the sinuses and the bone that encases the deep structures of the ear also make up part of the skull base. It also contains many nerves, blood vessels, and glands, and any damage or skull base tumor can affect vision, hearing, speech, swallowing, and can even be life-threatening. The basic concept of Skull Base Surgery is to approach the tumor from the undersurface of the Brain and tumor, or from the side, by removing specific parts of the bone of the Skull Base. This exposes the tumor with no damage to the Brain. The procedures are divided according to whether the tumor is involving the front part of the skull base (anterior cranial fossa) or the middle part of the skull base (middle cranial fossa). Endoscopic skull base surgery is a less invasive route to specific lesions and is implemented as a tool for the biopsy and removal of these lesions. Traditional approaches to anterior skull base lesions involve a craniotomy, such as the frontal, bifrontal, expanded bifrontal, frontotemporal orbitozygomatic, and transbasal approaches.

1.Skull base tumor surgery


Treatments for skull base tumors include medical intervention, radiation therapy, surgical intervention, or a combination. Some tumor at base of skull requires surgery but when surgery is required it is usually performed by a team comprising an ENT surgeon and a neurosurgeon. Sometimes other surgeons are also involved. This might include a plastic surgeon, maxillofacial surgeon or ophthalmic surgeon. The type of surgery performed depends on the site, type and size of the tumor as well as the expertise of the team. A tissue diagnosis is generally performed before the medical or radiation therapy. Chemotherapy, Radiation therapy or stereotactic radio surgery can be used to primarily treat a skull base tumor or can be used as adjuvant therapy after tumor surgery. A new approach removes pituitary tumors through a patient's nose, rather than through a large incision in the head. This endonasal, endoscopic, skull-based procedure results in a quicker recovery for patients with pituitary tumors and other tumors at the base of skull. Many of the complications seen with traditional tumor removal, such as numbness, pain and large incisions are avoided in this technique.
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