Skull Base Tumors
The skull base tumors can be found in the anterior, middle, and posterior compartments or fossae of the brain. Surgical approaches are often classified based on the involved area.
Surgery, radiation therapy, chemotherapy or a combination of therapies my be involved in skull base tumor treatment. Surgery for skull base tumors may involve either open or minimally invasive techniques.
Access to the skull base often involves an open surgical approach. Incisions are made in both the cranium and face, and a small portion of bone may be removed to provide access to the target area. Open surgery is recommended for some patients, depending in part on the type of tumor and its location. After the tumor is removed, plastic surgeons reconstruct the soft tissues and bone to provide the best possible function and appearance.
Minimally Invasive Surgery
Minimally invasive surgical techniques allow access to skull base tumors base with minimal external incisions. Access is provided by endoscopes, and visualization of the target area is enhanced through image-guidance and real-time magnetic resonance imaging (MRI).
Endoscopy: allows surgeons to access the tumor with an endoscope, a thin, flexible tube with a camera, which is inserted through tiny holes in the skull (neuroendoscopy), or through the nose and sinuses (sinonasal endoscopy). Endoscopes provide an accurate view and precise access to tumors in various regions of the skull base. Endoscopy reduces the extent of surgery as well as the patient’s hospital stay, complications and recovery time.
Image-guided surgery: With this technique, computed tomography (CT) scans or magnetic resonance (MR) images taken before surgery are used in the operating room to help guide the surgeon, acting as a type of navigation tool and confirming the precise location of the tumor. Intraoperative image guidance enhances the accuracy and precision of minimally invasive surgery of the skull base.
Real-time MRI: provides surgeons with precise, real-time images of the patient’s tumor and surrounding anatomy during surgery, increasing surgical accuracy and enhancing complete removal of the tumor. Real-time MRI helps surgeons to determine the completeness of tumor removal during minimally invasive techniques, and helps reduce the need for additional surgeries.