Skull Base Surgery

- Skull is a composition of bones and cartilages. These bones & cartilages form the face and the cranium surrounding the brain.
- Five bones form the bottom of the cranium. These bones form the eye socket, roof of the nasal cavity, few sinuses and the surrounding bones of the ear.
- Skull area has crucial openings that the spinal cord, many blood vessels, and nerves all pass through.
- Tumours both benign and cancerous ones which grow on the underside of the brain are removed by skull base surgery. Abnormalities over the underside of brain and in few cases on the top few vertebrae of the spinal column are removed by skull based surgery.
- The surgical area being complicated and crucial one, skull base surgery may be done by a minimally invasive endoscopic procedure. In such procedure insertion of instruments is through natural opening of the skull i.e. nose or mouth. In some case the insertion happens through a small hole just above the eyebrow.
- Team of specialists involved in this surgery are ENT surgeons, neurosurgeons and radiologists.
- In earlier times the only way to remove such growths in this area of the body was by making an opening in the skull. Now due to development and advancements in endoscopic skull base surgery there is minimum invasive endoscopic procedure.
- In some cases, an opening in the skull may be needed to remove the growth.


Growths and conditions that may be treated by skull base surgery :

- Cysts that develop from birth.
- Growths caused by infections.
- Pituitary tumors. The pituitary gland is behind the nose and eyes.
- Meningiomas. These tumor growths are from the meninges. It is a tissue that covers the brain and lies in between the brain and skull.
- Chordomas. This tumour grows slowly at the base of the skull.
- Trigeminal neuralgia, a growth with intense pain on one side of the face.
- Craniopharyngiomas, growths that occur near the pituitary gland.
- Craniosynostosis, a condition in infants in which the bones of the skull close too early. This causes brain problems and growth & shape of the skull are adversely affected.
- Cerebrospinal fluid fistulas.
- Cerebral aneurysm, a weak, often bulging area in a blood vessel in the brain.
- Arteriovenous malformations. These are arteries and veins that are abnormally connected to one another.


Types of skull base surgery


Endoscopic or minimally-invasive skull base surgery.

- An ENT surgeon makes a small opening inside the nose. This allows the neurosurgeon to remove the growth using an endoscope (it is a thin lighted tube). Radiologist takes MRI pictures which further help the neurosurgeon to ensure that the growth is completely removed.


Traditional or open skull base surgery.

-  This surgery makes incisions in the facial area and in the skull. Partial bone may need to be removed so that the growth can be reached and removed completely.


Symptoms


The following symptoms are shown to indicate any abnormality in the skull base area. Symptoms will depend on the size, type, and location of the growth or abnormality :

- Facial pain
- Headache
- Dizziness
- Visual problems
- Numbness
- Weakness of the face
- Hearing loss or ringing in the ears
- Nasal congestion or frequent sinus infections