Tumors come in all shapes and sizes and treatment is highly specific to a patient’s situation. In some instances, removal of an abnormal growth may be possible with an endoscopic approach to the anterior skull base. The procedure involves the use of a special technique to remove the tumor through the nose by going across the sinuses. It’s an alternative to procedures involving large incisions, increased complication risks, and lengthy healing and recovery times.
How Endoscopic Skull Base Surgery is Performed
The surgery is performed with a device called an endoscope. It’s an instrument with a lighting system that’s placed through the nose and sinus cavities to access the skull. Large retractors are not required to allow access via the nose. An angled endoscope may be used when the surgery is performed to reach the tumor cavity or to access areas located behind structures within the brain in a way that would not pose serious risk to the patient.
The technique is precise enough (because of the use of smaller, specialized instruments) to allow surgeons to reach some tumors and growths that could not be removed safely with traditional brain surgery. Cosmetic problems often associated with brain surgery are also unnecessary since there are no incisions on the scalp, face, nose, or underneath lips and no visible scarring. There’s even less of a chance of seeing noticeable scarring in the nose where instruments are inserted. Endoscopic procedures may allow patients to benefit from:
- Less time required to perform surgery
- Shorter hospital stays
- Fewer surgical risks
- Minimal pain or discomfort after surgery
- No radiation used intra-operatively
Many Possibilities with Endoscopic Skull Base Surgery
An endoscopic approach to the skull base has been used successfully on both adults and children with various types of tumors and lesions. While the procedure is often associated with brain tumors and metastases, it can be applied to many other issues that can affect the base of the skull and nearby areas, such rathke cleft cysts, hormonal disorders like acromegaly, cancer affecting the mucus-secreting glands (adenocarcinoma), and dermoid, epidermoid, and pituitary tumors. Procedures that may be performed with this approach to surgery also include:
- Cushing’s disease
- Invasive fungal sinusitis
- Optic nerve compression
- Squamous cell carcinoma
Treating Complex Disorders
Skull base surgery performed with endoscopic techniques holds promise for patients who have complex tumors that would otherwise be either inoperable or difficult to remove. Patients typically receive a treatment plan based on imaging studies and a comprehensive assessment of the growth to determine if endoscopic surgery is appropriate.
Computer-assisted navigation used during the procedure offers the surgeon a detailed look at the affected area of the brain. The 3-D views produced by the computers allow for better visualization of the tumor in terms of location and size. Imaging may also be used when an endoscopic approach to the anterior skull base is performed to remove a problematic growth to confirm that the tumor has been completely eliminated.