Skull base surgery is a specialized type of surgery focused on removing tumors or repairing defects at the base of the skull, where the brain meets critical structures like the nerves, blood vessels, and sinuses. This area is complex and difficult to access, so skull base surgery often involves advanced techniques and a multidisciplinary team (neurosurgeons, ENT specialists, head and neck surgeons, etc.).
What Is the Skull Base?
The skull base is the bottom part of the skull and includes:
- Anterior skull base: behind the forehead and nose.
- Middle skull base: around the eyes and upper cheeks.
- Posterior skull base: near the brainstem and cerebellum.
It supports the brain and houses crucial structures like:
- Optic nerves
- Cranial nerves
- Major blood vessels (carotid artery, jugular vein)
- Nasal passages and sinuses
🏥 Indications for Skull Base Surgery
- Benign or malignant tumors:
- Meningioma
- Schwannoma (e.g. acoustic neuroma)
- Pituitary adenoma
- Chordoma or chondrosarcoma
- Esthesioneuroblastoma
- Skull base metastases
- Cerebrospinal fluid (CSF) leaks
- Congenital skull defects
- Trauma (fractures, hematomas)
- Infections or abscesses
- Vascular malformations
⚙️ Surgical Approaches
- Endoscopic Skull Base Surgery (Minimally Invasive)
- Uses an endoscope through the nose or sinuses (no external cuts).
- Common for pituitary tumors, CSF leaks, and small tumors.
- Faster recovery, fewer complications, no visible scars.
- Open Skull Base Surgery
- Involves external incisions (e.g., through the face or cranium).
- Required for large, complex, or highly vascular tumors.
- May include craniotomy (opening part of the skull).
- Combined Approaches
- Some cases use both endoscopic and open techniques for safety and full tumor access.
⏱️ Recovery and Risks
- Hospital stay: 2–10 days depending on the surgery.
- Recovery time: Several weeks to months.
- Risks:
- Bleeding, infection
- CSF leaks
- Vision or hearing loss
- Facial weakness or numbness
- Hormonal imbalances (especially with pituitary tumors)
- Stroke or neurological deficits (rare)
🧑⚕️ Multidisciplinary Team
Skull base surgeries usually involve:
- Neurosurgeons
- Otolaryngologists (ENT)
- Head and neck surgeons
- Endocrinologists (for hormonal tumors)
- Radiologists and pathologists
- Radiation and medical oncologists (for cancer cases)