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Surgery on the anterior skull base may be required to remove abnormalities that have developed on the skull base and remove both cancerous and noncancerous growths
Surgery on the anterior skull base may be required to remove abnormalities that have developed on the skull base and remove both cancerous and noncancerous growths:
- Cysts
- Growths caused by infections
- Noncancerous tumors
- Cancerous tumors
- Pituitary tumors
- Cerebrospinal fluid fistulas
When is anterior skull base surgery recommended?
The human skull is made up of bones and cartilage that form the cranium, which surrounds the brain and face. The skull base is an important area of the body because it contains openings through which different blood vessels, nerves, and the spinal cord pass through.
To determine whether anterior skull base surgery is the best treatment, the following factors are considered:
- Location of the tumor
- Size of the tumor
- Type of tumor
- Overall condition of the patient
Symptoms that may indicate the need for anterior skull base surgery include:
- Vision problems and difficulty in eye movements
- Unintentional weight loss
- Difficulty breathing
- Weakness in muscles and joints
- Irregular menstrual periods
- Erectile dysfunction
- Reduced other sensory functions
- Nosebleeds or nasal congestion
- Frequent sinus infections
An anesthesiologist, a rhinologist, and a neurosurgeon work together during the surgery to provide the best outcome for the patient.
What are different types of anterior skull base surgery?
There are two types of skull base surgery that may be considered:
- Endoscopic surgery: This is a minimally invasive surgery in which small incision is made in the nose to insert a thin and flexible tube called endoscope
- Traditional surgery: Also called open craniotomy, this type of surgery involves removing a piece of bone from the forehead so surgeons can access the tumor
Endoscopic skull base surgery
This is the most preferred method of surgery because it is minimally invasive. This technique helps surgeons access the tumor through the nasal cavities and sinuses.
- An endoscope is inserted through the nose and transmits images of the tumor through a long, thin tube.
- Using microsurgical instruments, the tumor is cut out while taking proper precautions to carefully preserve the normal structures and tissues surrounding the tumor. The area can be restored with healthy tissue taken from inside the nose or from other parts of the body if needed.
- A spinal drain is temporarily installed to divert excess cerebrospinal fluid and promote healing. The drain is removed a few days after surgery is done.
- After the surgery, patients are advised to stay in the hospital for 4-7 days. Surgeons monitor the condition of the patient and prescribe imaging tests if required.
Medications are prescribed to prevent seizures or swelling. Patients may be advised to do light exercises and avoid vigorous activities after the surgery. Patients may resume normal daily activities within a week of surgery, but recommended precautions should be followed.
Traditional or open skull base surgery
This approach is used when the tumor cannot be reached through endoscopy.
- Neurosurgeons temporarily remove a piece of the skull to access the tumor.
- During a craniotomy, a large surgical microscope is used to view the tumor, and scans from previous medical evaluations guide the surgeons during the process.
- Once the surgery is completed, the piece of the skull is replaced.