Skull base tumors, which may present with nasal congestion, sinus problems, facial pain, headache or vision problems, can progress silently in some cases. Tumors can also be difficult to treat, as the skull base is a complex and hard-to-reach area. However, with endoscopic methods developed in recent years, even extremely complex clinical manifestations in skull base tumors can be successfully treated. From growths and abnormalities in the skull base; It is possible to get rid of it with multidisciplinary treatment approaches applied by branches such as otorhinolaryngology, brain and neurosurgery, oral and maxillofacial surgery and eye diseases. Associate Professor from Memorial Şişli Hospital, Department of Otorhinolaryngology, Head and Neck Surgery. Dr. Şenol Çomoğlu gave information about skull base surgery.
The skull base is an inaccessible and complex area.
Rhinology is the science that deals with all kinds of diseases and surgical treatment of the nose and its surroundings. Basically, all kinds of diseases of the face, sinuses and nose are the subject of rhinology. Rhinology and skull base surgery is a special field of ENT diseases. The roof of the nasal cavity and some sinuses forms the base of the skull, in which the brain is located. Skull base surgery can be done to remove both noncancerous and cancerous growths and abnormalities in the lower part of the brain, skull base, or upper few vertebrae of the spine. This area is very difficult to see and reach. Computed Tomography (CT) or Magnetic Resonance imaging (MR) techniques can detect these abnormalities with a high degree of accuracy.
Skull base tumors can have many symptoms.
There are many possible complaints from a growth or abnormality in the skull base area. Symptoms can vary depending on the size, type, and location of the growth or abnormality. Symptoms include persistent nasal congestion or frequent sinus infections, nasal bleeding, which is often unilateral in adulthood, facial pain, headache, imbalance, problems with vision, facial numbness or weakness. Some diseases in which skull base surgeries are applied are as follows;
- CSF fistulas (brain fluid coming from the nose)
- Sinus and nasal tumors extending to the skull base
- Some congenital cysts
- Pituitary tumors
- Meningiomas (non-cancerous growths of the cerebral cortex) in this area
- Chordoma (slow-growing tumors of intraosseous origin, often originating from the skull base)
- Craniopharyngioma (tumoral growths near the pituitary gland)
Surgeries can often be performed endoscopically.
Surgical treatment includes both open and minimally invasive (without incision) techniques, depending on the type and location of the tumor. Before endoscopic skull base surgery was developed, the only way to remove growths in this part of the body was to make a hole in the skull, and today this type of surgery may be required in some cases. Today, skull base surgery can be performed with a minimally invasive procedure through natural openings in the skull (nose or mouth) or endoscopically by making a small hole just above the eyebrow.
2 methods can be applied together in skull base surgery
Skull base surgery is basically performed with two methods. Although sometimes these two methods can be used together, the endoscopic method is preferred if possible. In some cases, the open method is unavoidable. In the endoscopic method, the surgeon often performs the surgical procedure by using the nose, sometimes other openings such as the mouth or eyes, or by making a small incision into the eyebrows and proceeding from there. The biggest advantage of this method is that it affects the comfort and quality of life of the patient both during and after the operation very little compared to the open method. Most of the patients are discharged after one or two days of hospitalization and return to their daily lives. The traditional open method is still inevitable in some diseases of this region. It is often preferred when it comes to areas that cannot be reached by endoscopic method. In this method, a large incision is made on the face or skull from the scalp area, and surgery is performed. If a cancer-containing tumor is being treated, additional treatment may be needed after endoscopic surgery, sometimes before, depending on the condition and spread of the disease. These are often chemotherapy and radiotherapy treatments administered by the oncology unit. Follow-up of these patients will also need repeated imaging (CT or MRI) to ensure there is no recurrence.
Source: (BYZHA) – Beyaz News Agency
