Skull Base Surgery

Skull base surgery is a procedure done to eliminate cancerous or benign growth and brain abnormalities present in the underside of the brain. This surgery is done at the base of the skull and at the top of the first few vertebrae on the spinal cord. Since it is a comparatively difficult area to reach, this is usually an endoscopic skull base surgery rather than an open surgery. Based on the symptoms, the type of growth and its location, your surgeon will advise the best type of surgery.

INDICATIONS
A neurosurgeon will recommend skull base surgery procedures for patients suffering from the following medical ailments:

  • Cysts present in the brain from the time of birth
  • An unexpected growth occurring as a result of some infection
  • Chordomas – a kind of bone cancer in a malignant form
  • Pituitary Tumours
  • Craniopharyngiomas
  •  A birth defect in the skull known as Craniosynostosis
  • Trigeminal Neuralgia – A condition in the trigeminal nerve that causes chronic pain to the patient • Cerebral aneurysm
  • Arteriovenous malformations – the arteries and veins create an abnormal connection that tends to circumvent the capillary system

Cerebral spinal fluid leakage through the skull bone Patients with some kind of abnormality in the base of the skull may experience the following symptoms:

  • Dizziness and visual problems
  •  Severe headache
  • Hearing loss or constant ringing in the ears
  • Facial pain and weakness of the face
  • Nasal congestion and constant sinus infections
  • Numbness If you are experiencing any of the above problems, it is best to consult a neurosurgeon at the earliest.

You can call our doctors at any time and discuss your symptoms and the treatment plan ahead.

PRE-PROCEDURE
As the skull base cannot be examined with the naked eye, medical tests and exams play a crucial role in the prognosis of cranial base surgery. Normally, your doctor will recommend the following tests before planning your surgery:

  • A series of brain imaging tests including CT scans, MRIs, PETs, MRAs to clearly see the inside of the skull and identify the need for invasive or minimally invasive spine surgery.
  • A biopsy is done to check for any cancerous growth in the area
  • The doctor’s team will also conduct a physical exam to test the patient’s balance, cranial nerves for any hampered reactions, dips in muscle activity and a test for blurred vision and hearing ability

DURING PROCEDURE
As this is an extensive surgery, the patient is given general anaesthesia for about 24 hours. For additional comfort, the patient is kept on a heating blanket that is positioned over an alternating pressure air mattress. When the main blood vessel, the petrous carotid is dissected, the patient’s blood pressure is purposely kept abnormally low. In the past, many patients experienced bleeding during surgery and thus, doctors today start fresh frozen plasma and platelet infusions once the patient has gone through 4 units of blood. This has become a standard procedure in modern times and has proved to prevent the potentially fatal intracranial bleeding during and post the surgery.

  • For an endoscopic surgery, the neurosurgeon makes a small cut in the nose through which the extra growth removal is possible. An endoscope, a thin tube with a light in the front is used to guide the surgeon towards the growth.
  • Before completing the surgery, the teams uses MRI scans to make sure that all the growth has been properly removed.
  • In the case of an open surgery, the doctor will make a large incision behind the hairline. In order to clearly reach the growth and eliminate it properly, the surgeon will have to remove parts of the bone from the bottom of the skull.
  • These are then reattached post the removal of abnormal growth from the skull base. Apart from endoscopic and open surgical procedures, many doctors will also recommend chemotherapy and radiation to patients with cancerous growths in their craniums.

POST PROCEDURE
After a skull cancer spine surgery, the patient is moved to the ICU and continuously monitored by their doctor and nurses. At this stage, the patient’s respiratory parameters need to be adequate and the patient should be able to maintain his blood oxygen saturation while being incubated and spontaneously breathing. Normally, patients can go home after 7 to 10 days, once all their reports are fine. However, complete recovery after this kind of surgery might take a few months and therefore, patients must take good care of themselves and avoid heavy activities.

RISK AND COMPLICATIONS
Whether it is an open skull surgery or an endoscopic procedure, skull base surgery is a highly complicated procedure and thus, brings a large amount of risks and complications for the patient. Your doctor will explain all the possible risks of the surgery beforehand so that you can take a well-informed decision. Some common known risks include: • Bleeding inside the skull

  • Cranial nerve loss, also known as nerve loss in the skull
  • Pneumothorax – a medical condition in which air of gas gets accumulated in the cavity between the lungs and chest
  • Inability of blood to clot, medically known as Coagulopathy
  • In rare cases, stroke and sudden death
  • Seizures
  • Rupturing of the carotid arteries
  • Loss of vision
  • Cerebrospinal fluid leakage
  • Cerebral edema – build-up of fluid in the brain
  • Trouble in swallowing
  • Unusual alterations in voice or hoarseness
  • Hypopituitarism, reduction in the secretion of hormones in the pituitary gland

MORE INFO
Patients can find excellent treatment and care in India in Mumbai, Chennai, Kolkata, Hyderabad, Delhi and Bengaluru at economical prices. The neuro-speciality hospitals in India promote excellent surgical facilities along with state-of-the-art infrastructure. If you’re looking for a bone cancer skull surgery or any other kind of skull base procedure, trust our doctors to give you the right and relevant information. Feel free to talk to your doctors on and get assured treatment and positive results for your ailment.

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