Search - Skull Base Surgery

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Description

Skull Base Surgery is a surgical procedure done at the base of the skull and the top of the initial few vertebrae on the spinal column to eliminate cancerous as well as benign growths and brain abnormalities lying on the underside of the organ. Since the area is difficult to view and reach for a doctor, it is usually done through an endoscopy as compared to an open surgery. The type of surgery depends on the sort of growth that needs removal and location of the growth.

Symptoms

Skull base surgery is recommended to treat the following medical conditions Cysts that are present since the time of birthGrowths occurring as a result of infectionsPituitary tumoursChordomas - type of bone cancer in malignant formTrigeminal neuralgia - a condition of the trigeminal nerve of the brain which results in chronic painCraniopharyngiomasCraniosynostosis - a birth defect associated with the skullCerebrospinal fluid fistulas - a condition associated with leakage of cerebral spinal fluid through the skull boneCerebral aneurysmArteriovenous malformations - a medical condition in which the arteries and veins form an abnormal connection that circumvents the capillary system Cysts that are present since the time of birth Growths occurring as a result of infections Pituitary tumours Chordomas - type of bone cancer in malignant form Trigeminal neuralgia - a condition of the trigeminal nerve of the brain which results in chronic pain Craniopharyngiomas Craniosynostosis - a birth defect associated with the skull Cerebrospinal fluid fistulas - a condition associated with leakage of cerebral spinal fluid through the skull bone Cerebral aneurysm Arteriovenous malformations - a medical condition in which the arteries and veins form an abnormal connection that circumvents the capillary system Possible symptoms of any abnormality in the base of the skull are Facial painHeadacheDizzinessVisual problemsNumbnessWeakness of the faceHearing loss or ringing in the earsNasal congestion or frequent sinus infections Facial pain Headache Dizziness Visual problems Numbness Weakness of the face Hearing loss or ringing in the ears Nasal congestion or frequent sinus infections

Pre Procedure

Since the skull base area cannot be examined with the naked eye, the exams become an important part of the prognosis. The doctor will suggest the following before the surgery Brain imaging tests like MRIs, MRAs, PETs, and CTs are scans which show inside of the skull and help to visually identify if there is any need for further invasive proceduresBiopsy to check for any cancerous growth. Physical exams like testing the patientís balance, checking the cranial nerves for hampered reactions, checking dips in muscle activity, testing for blurry vision and hearing ability. Brain imaging tests like MRIs, MRAs, PETs, and CTs are scans which show inside of the skull and help to visually identify if there is any need for further invasive procedures Biopsy to check for any cancerous growth. Physical exams like testing the patientís balance, checking the cranial nerves for hampered reactions, checking dips in muscle activity, testing for blurry vision and hearing ability.

During Procedure

During surgery, the patient is usually put under general anaesthesia for around 24 hours. The patient is usually kept on a heating blanket positioned over an alternating pressure air mattress as the procedure is an extensive one. The patientís blood pressure is intentionally kept abnormally low, especially when the main blood vessel, the petrous carotid, is dissected. Usually, past experience with bleeding during surgery will ensure that doctors start fresh frozen plasma and platelet infusions after the patient has gone through at least 4 full units of blood. This practice is usually standard procedure, and has been shown to prevent potentially deadly intracranial bleeding during and after the surgery.Minimally-invasive or Endoscopic skull base requires a small cut in the nose through which removal of growths by a neurosurgeon is made possible. The neurosurgeon uses an endoscope, which is a very small, very thin tube with a light attached at the front. The operating team usually takes the help of an MRI to make sure that all of the growth has been removed.Open Surgery requires a large incision, generally behind the hairline. To reach and eliminate the growth, the surgeon needs to remove parts of bone from the bottom of the skull. Along with endoscopic and open surgery, chemotherapy and radiation therapy si also required for patients with cancerous growths in their craniums.

Post Procedure

Post completion of the skull base surgery, the patients are monitored continuously in the ICU. Respiratory parameters have to be adequate, and the patient should be able to maintain blood oxygen saturation while incubated and spontaneously breathing.Generally, the patients can go home in 7 to 10 days after the surgery. Complete recovery may take a couple of months or more.

Risk And Complications

Skull Base surgery is a complicated surgery. Risks associated with the surgery are: Pneumothorax - accumulation of air of gas in the cavity between the wall of the chest and lungsCranial nerve loss or nerve loss in the skullCoagulopathy or inability of the blood to clotStroke and death, in some casesRupture of the carotid arteries Bleeding inside the skullCerebral edema - Fluid buildup inside the brainSeizureHypopituitarism - reduction in pituitary gland's secretion of hormonesLeakage of Cerebrospinal fluidLoss of VisionDysphagia or trouble in swallowingHoarseness or unusual alterations of voice Pneumothorax - accumulation of air of gas in the cavity between the wall of the chest and lungs Cranial nerve loss or nerve loss in the skull Coagulopathy or inability of the blood to clot Stroke and death, in some cases Rupture of the carotid arteries Bleeding inside the skull Cerebral edema - Fluid buildup inside the brain Seizure Hypopituitarism - reduction in pituitary gland's secretion of hormones Leakage of Cerebrospinal fluid Loss of Vision Dysphagia or trouble in swallowing Hoarseness or unusual alterations of voice
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