Anterior Skull Base Surgery
It used to be that when someone said they had a tumor pushing on their optic nerve or a pituitary tumor, their options were slim. Many of these sites are inoperable through traditional open surgery. But with the advent of the endoscope in the 1980s and its ever-evolving uses since 2000, everything has changed.
Welcome to anterior skull base surgery, one of the truly amazing areas in medicine, both for what it can do and for how fast things are advancing.
What is the skull base, particularly the anterior skull base?
The skull base is an irregular bone surface on which the brain rests. The spinal cord, multiple nerves, and the major blood vessels of the brain, head, and neck pass through openings in the skull base.
This base is divided into three regions — the anterior, middle, and posterior. At Coastal Ear, Nose, and Throat, we provide comprehensive care for patients with pathology affecting the anterior skull base. This is the region above a person’s eyes and behind the nose.
What is skull base surgery?
Skull base surgery involves procedures performed not within the brain, but at the skull base behind the nose. This surgery has been transformed with minimally invasive techniques that allow the surgeon to enter through the nostrils. These are the natural openings in the face, so no incisions are required. Tiny endoscopes are used to find the lesions and remove them without making a single incision.
This area of skull base surgery is also called endonasal neurosurgery. By entering through the nostrils, the surgeon is able to maneuver the endoscope to different areas to allow treatment of brain tumors in different locations. The endoscope can be directed downward to see the palate and the back of the throat to operate on the top of the spine and the base of the skull. Access to these areas through traditional open surgery is almost impossible.
On what conditions can anterior skull base surgery be used?
Anterior skull base surgery can remove very large tumors through the nostrils, without a single incision. Pituitary tumors, meningiomas, craniopharyngiomas, and other tumors can all be removed through anterior skull base surgery by the team at Coastal Ear, Nose and Throat, including our fellowship trained Rhinologist, Dr. Josef Shargorodsky. Many of these tumors are benign, but they often can cause problems with vision, growth, fertility, and balance.
Faster Procedures, Faster Recoveries
Without the need for large incisions on the scalp and skull, the procedures become simpler and quite fast compared to traditional methods. There isn’t any scarring and recovery involves far less pain. Patients usually can return home after just a day or two in the hospital, and return to their normal activities quickly.