What is Skull Base Surgery?

The skull base is formed by the bones of the skull that surround the brain and the bones that make up the face. The bones at the lower part of the skull include those surrounding the eye socket, the roof of the nasal cavity, some sinuses, and the inner ear. The skull base is a complex region through which numerous blood vessels, nerves, and the spinal cord pass.

Skull base surgery may be performed to remove non-cancerous or cancerous growths or abnormalities located at the lower part of the brain, the skull base, or the upper vertebrae of the spine. Accessing and visualizing this area is extremely challenging. The treatment of skull base pathologies requires a multidisciplinary approach. A skull base surgical team typically involves collaboration among neurosurgery, otolaryngology (ENT),maxillofacial surgery, orbital surgery, interventional radiology, radiation oncology, medical oncology, and, when needed, plastic surgery for reconstruction.

When is Skull Base Surgery Used?

Congenital cysts
Growths due to infections
Tumors of the nasal cavity and paranasal sinuses (sinonasal tumors)
Pituitary tumors
Meningiomas (tumors of the meninges)
Slow-growing bone tumors at the lower skull base (chordomas)
Severe unilateral facial pain (trigeminal neuralgia)
Growths near the pituitary gland (craniopharyngiomas)
Cerebrospinal fluid fistulas
Weak, often bulging areas in brain blood vessels (aneurysms)
Arteriovenous malformations (abnormal blood vessel connections)
Orbital (eye socket) masses

These conditions often present with specific symptoms such as vision loss, nosebleeds, nasal congestion, facial numbness, asymmetric hearing loss, head/face pain, balance problems, or hormonal imbalances. Symptoms usually develop gradually and are diagnosed by an ENT specialist and/or a neurosurgeon using computed tomography (CT) scans and magnetic resonance imaging (MRI). Additional specialized tests, such as hearing tests, visual field tests, or arterial studies, may also be performed.