Tumors located at the base skull present several challenges for both patients and surgeons, mainly because of location.
One way to reduce the risks associated with accessing skull base tumors is with minimally invasive endoscopic skull base surgery. It’s an endoscopic procedure that involves tumor removal through the nose via sinus cavities and passages.
With this procedure, patients often enjoy welcome relief from symptoms from pressure on nerves and other structures.
How it’s Done
This type of surgery is performed with a special lighted tube called an endoscope. Specially designed instruments are used to remove the skull base tumor through the nose and adjacent passageways. Prior to surgery, image tests are usually done to precisely determine or confirm the location of the tumor or abnormality.
What Are Possible Benefits for Patients?
Because the procedure is done internally, there are no incisions and no scars on the face, scalp, or upper neck. Discomfort for patients is often minimal, including post-surgery pain. Additionally, the use of an angled endoscope means that tumors can sometimes be reached in ways not possible with traditional open procedures. Patients also typically benefit from shorter recovery periods and fewer post-surgery issues. The specific length of recovery will depend on factors such as the size of the tumor and a patient’s overall health.
Who May Benefit from Less Invasive Skull Base Surgery?
A minimally invasive, endoscopic approach to skull base surgery sometimes allows hard-to-reach tumors that would otherwise be considered inoperable to be safely removed. It’s a type of surgery that can be used on both children and adults with tumors and other abnormalities requiring removal or corrective procedures. Ideally, it’s preferred that patients do not have any serious underlying health problems like uncontrolled diabetes or heart conditions, although it may be possible to work around such issues.
Uses of Skull Base Surgery
While primarily performed on patients with brain tumors, minimally invasive endoscopic skull base surgery may be used to treat other conditions affecting this area. For instance, fluid-filled arachnoid cysts sometimes develop around the base of the skull by membranes that cover the brain. Other patients may have issues with optic nerve compression or a cerebrospinal fluid (CSF) leak that hasn’t healed on its own or responded well to conservative treatments. Endoscopic skull base surgery may also be done as part of treatment for any of the following conditions:
- Sinus tumors
- Invasive fungal sinusitis
- Issues related to Cushing’s disease
- Neural tube defects like encephalocele
- Tumors that developed in the pituitary gland
- Increased skull pressure not linked to a tumor (pseudotumor cerebri)
Additional technology that may improve results when surgery is necessary for skull base tumors includes the use of MRI imaging during surgery to make sure all affected tissues are removed and computer-assisted imaging navigation, which provides added 3D visualization of the affected area during the procedure. For situations where any type of surgery is too risky, a specialist may recommend a combination of radiation therapy and chemotherapy to shrink the growth.