Skull Base Surgery

Skull base surgery is a minimally invasive surgical procedure to treat both- benign and cancerous tumors present in the base of the skull or the top vertebrae. This method of treatment is better than an open surgery as the instruments are inserted through the natural openings of the skull instead of a large incision through the cranium. The skull can be accessed through three ways- Trans-nasal, Trans-oral and Supra-orbital. A skull base surgery is required in the conditions of cerebral aneurysm, meningiomas, craniopharyngiomas, chordomas, pituitary tumors and other skull disorders. 

Know More About Surgery

A skull base surgery may be required when the following symptoms appear:

  • Facial pain
  • Headache
  • Dizziness and Weakness of the facial muscles
  • Numbness and loss of sensation 
  • Changes in personality
  • Vertigo and trouble to balance
  • Facial twitching
  • Loss of hearing
  • Loss of vision or Double vision
  • Bulging of the eyeball
  • Nasal congestion
  • Frequent nose bleeding
  • Sinus infections 

The requirement of a skull base surgery can be diagnosed by several imaging tests such as MRI, MRA, PET and CT scans which form detailed pictures of the skull and the tumors can be examined with precision. A biopsy is essential to observe abnormalities in the brain tissue as a small piece of the growth is taken out from the skull and is observed under the microscope. Other tests such for vision, smell, hearing and other senses are also carried out.

Skull base surgery is essential for the treatment of many skull disorders. It can be carried out in two ways: 
  • Minimally invasive skull base surgery is carried out through the nose, mouth or below the eyebrow and does not require a craniotomy. An endoscope is inserted through the opening which helps getting images of the tumors inside the skull and hence can be treated on with precision.
     
  • Open skull base surgery requires large incisions to be made in the skull. Parts of the bone and surrounding tissue also have to be removed in order to reach the tumors affectively. 
A suitable method is decided according to the size and location of the tumor. Along with the skull base surgery, chemotherapy, gamma knife and radiation therapy may also be essential to remove the cancerous growth.

There are several risks of Skull base surgery such as infection at the site of incision. There are also chances of hemorrhage, nerve injuries and brain damage. There may be a leak of the cerebro-spinal fluid which can cause further disorders of the brain. Eye complications such as blindness, vertical dystopia, double vision, canthal drift and many more can also occur. 

After skull base surgery, the patient is required to take sufficient rest. The patient regularly gets tested to ensure that the tumors don’t form again. The patient must call the doctor in case of:
  • High fever
  • Nausea and Vomiting
  • Infections at site of incision
  • Too much pain in the arm
  • Any kind of discomfort 

Skull Base Surgery from best Hospitals and Doctors in Mumbai Region

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Skull Base Surgery

Skull base surgery is a minimally invasive surgical procedure to treat both- benign and cancerous tumors present in the base of the skull or the top vertebrae. This method of treatment is better than an open surgery as the instruments are inserted through the natural openings of the skull instead of a large incision through the cranium. The skull can be accessed through three ways- Trans-nasal, Trans-oral and Supra-orbital. A skull base surgery is required in the conditions of cerebral aneurysm, meningiomas, craniopharyngiomas, chordomas, pituitary tumors and other skull disorders. 

Symptoms

A skull base surgery may be required when the following symptoms appear:

  • Facial pain
  • Headache
  • Dizziness and Weakness of the facial muscles
  • Numbness and loss of sensation 
  • Changes in personality
  • Vertigo and trouble to balance
  • Facial twitching
  • Loss of hearing
  • Loss of vision or Double vision
  • Bulging of the eyeball
  • Nasal congestion
  • Frequent nose bleeding
  • Sinus infections 

Diagnosis

The requirement of a skull base surgery can be diagnosed by several imaging tests such as MRI, MRA, PET and CT scans which form detailed pictures of the skull and the tumors can be examined with precision. A biopsy is essential to observe abnormalities in the brain tissue as a small piece of the growth is taken out from the skull and is observed under the microscope. Other tests such for vision, smell, hearing and other senses are also carried out.

Treatment

Skull base surgery is essential for the treatment of many skull disorders. It can be carried out in two ways: 
  • Minimally invasive skull base surgery is carried out through the nose, mouth or below the eyebrow and does not require a craniotomy. An endoscope is inserted through the opening which helps getting images of the tumors inside the skull and hence can be treated on with precision.
     
  • Open skull base surgery requires large incisions to be made in the skull. Parts of the bone and surrounding tissue also have to be removed in order to reach the tumors affectively. 
A suitable method is decided according to the size and location of the tumor. Along with the skull base surgery, chemotherapy, gamma knife and radiation therapy may also be essential to remove the cancerous growth.

Risks

There are several risks of Skull base surgery such as infection at the site of incision. There are also chances of hemorrhage, nerve injuries and brain damage. There may be a leak of the cerebro-spinal fluid which can cause further disorders of the brain. Eye complications such as blindness, vertical dystopia, double vision, canthal drift and many more can also occur. 

After Procedure

After skull base surgery, the patient is required to take sufficient rest. The patient regularly gets tested to ensure that the tumors don’t form again. The patient must call the doctor in case of:
  • High fever
  • Nausea and Vomiting
  • Infections at site of incision
  • Too much pain in the arm
  • Any kind of discomfort 

FAQ Section

1) What is Skull Base Tumour?

Skull based tumor is the medical condition characterized by the growth of abnormal cells in the part of the brain that meets the base of the skull i.e. the bones of the skull that form the bottom of the head and the bony ridge behind the nose and the ears. Most of the skull based tumors are benign and do not spread to the rest of the body.

2) What does Skull Base mean?

The skull base is a crowded and complicated region with different openings through which the spinal cord, many blood vessels, and nerves all pass through. It is the region which separates the brain from the remaining anatomic structures of the head, which includes the sinuses, eyes, and ears.

 

3) What is Skull Base Surgery?

Skull based surgery is a highly complicated, minimally invasive surgical technique for evaluating, diagnosing and treating benign or cancerous growths located on the base of the skull. The complexity of this procedure increases as it is a multi-disciplinary task which combines the skills of otolaryngology, neurosurgery, neuro-radiology, anesthesia, intensive care medicine and physical and rehabilitative fields of medicine for the treatment and diagnosis of any tumors of the anterior, middle and posterior base of the skull.

4) What is the Skull Base Centre?

A skull base center, also known as cranial base center is a term describing the approach which is used to care for patients requiring intensive care, who are suffering from complex diseases at the base of the skull. It has been observed that no single physician, surgeon or nurse can provide the complete care required for the treatment of these patients. Thus, it can be termed as the combined skills and efforts of several professionals in order to suffice the treatment of the patient. The professionals involved can be an otolaryngologist, a neurosurgeon, a radiologist, an intensivist, the anesthesiologist, skilled nurses both in the intensive care unit and on the floor, as well as the physicians and nurses in rehabilitative and physical medicine.

5) What is the Endoscopic Endonasal Approach?

The Endoscopic Endonasal Approach is an advanced surgical method which enables the removal of any tumor or malignant cells through the nose. It is a complicated and multi-disciplinary procedure involving a team of specialists like otolaryngologist, a neurosurgeon, a radiologist, an intensivist, the anesthesiologist etc. In this approach, the tumor in the skull base is reached by directly operating through the nose and the sinuses. This procedure helps in removing large tumors without destroying or disfiguring the shape of the face or skull.

6) Where is the surgery performed?

This surgery is performed through the nose or sinuses in order to reach the lesions or tumors located in the base of the skull. It makes use of an endoscopic lens which is specially designed for the viewing and transmitting of internal images. This is associated with the use of highly specialized instruments for the operation procedure to be carried out and the removal of the tumor. It is performed in various top hospitals who have the required instruments and physicians to perform this level of complex operation.

7) Who performs the surgery?

The surgery is performed by a highly specialized multi-disciplinary team of medical professionals which include an otolaryngologist, a neurosurgeon, a radiologist, an intensivist and an anesthesiologist.

8) How long does the procedure take?

These cases usually are scheduled for an entire day. The duration of a case with average complexity may last from about six to ten hours and rarely longer. However, in selected instances, a case must be planned combined with several surgeries planned over a period of several weeks or months.

9) What tests will the patient need?

The patient must go through a thorough diagnosis prior to surgery. Although every patient’s condition is unique, ordinarily the diagnostic tests which are required for the diagnosis and planning of the surgery are

  • computed tomogram (CT scan)
  • magnetic resonance imaging and/or magnetic resonance angiography (MRI/MRA)
  • tests of hearing, balance, and facial nerve function
  • blood tests
  • A biopsy prior to surgery.
  • For vascular diseases, the patient may require angiography as well as embolization prior to surgery.

10) What should expect after the Skull Base Surgery?

After your surgery, you may be hospitalized until complete recovery. You may be under critical observation ranging from a period of few days to several weeks depending upon your condition. After discharge, you may be required to pay frequent visits to your doctor and undergo several imaging tests.

11) How long will the patient be in the hospital?

The length of hospitalization will depend upon the complexity of the disease. On average, the length of stay for a skull base tumor can range between four to ten days. If any problem arises following the operation or there is a need for post-operative rehabilitation, then the hospital stay will be extended. No patient is ever discharged from the hospital until complete recovery is done.

 

12) Skull Base Surgery cost in India?

A skull based surgery may cost approximately around four lakhs in India.