Editorial, J Otol Rhinol Vol: 10 Issue: 6
Skull Base Surgery: An Overview
Department of Otolaryngology, Poznan University of Medical Sciences, Poznan, Poland
*Corresponding author: Kazmierczak H, Department of Otolaryngology, Poznan University of Medical Sciences, Poznan, Poland, E-mail: [email protected]
Received date: 10 May, 2021; Accepted date: 24 May, 2021; Published Date: 01 June, 2021
Keywords: Skull Base
Skull base surgery is performed to remove a tumour or other growth from the base of the skull, often known as the bottom. Endoscopic skull base surgery, also known as minimally invasive skull base surgery, is a surgical method that allows surgeons to perform this delicate procedure via the nose. It is a highly specialised, minimally invasive surgical procedure for examining, identifying and treating benign or malignant growths situated on the bottom of the brain, the base of the skull and the top vertebrae of the spinal column. The bottom of the skull, or the bone plate upon which the brain sits, is referred to as the "skull base." The skull base is a crucial part of the head because it divides the brain from the rest of the anatomical components. Skull base surgery is used to treat a wide range of benign tumours. Acoustic neuroma, meningioma, schwannoma, glomus jugulare and vagale, epidermoid, pituitary tumours, and many more are examples. Squamous cell carcinoma, esthesioneuroblastoma, chondrosarcoma, chordoma, and endolymphatic sac tumours are among the malignant tumours treated by skull base surgery. A skull base biopsy may be necessary to detect various illnesses such as leukaemia, lymphoma, plasmacytoma, Langerhans' dell histiocytosis, rhabdomyosarcoma, osteosarcoma, fibrosarcoma, hemangiopericytoma, malignant fibrous histiocytoma, or metastatic disease, particularly in the juvenile population.
Skull base surgical methods are also used to repair skull base fractures, treat cerebral aneurysms, and remove deep-seated infections of the skull base bone. Tumors originating at the base of the skull are uncommon and typically cause minimal symptoms until they grow large enough to interfere with neurologic function. These symptoms might include double vision, face discomfort or twitching, hearing loss, dizziness or loss of balance, hoarseness, or tongue weakness. When a middle ear lump is discovered during normal ear examination, an asymptomatic tumour may be identified. An MRI of the brain and/or skull base, with and without gadolinium contrast, is very sensitive in detecting these uncommon tumours and poses little danger to the patient.
To assess the condition of the surrounding skull base bone, a CT scan of the skull base or temporal bone may be required. An MRA or magnetic resonance angiography and Magnetic Resonance Venogram (MRV) may be used to investigate how the tumour affects the blood arteries to the brain. An angiography with embolization may be performed prior to surgical excision for big or extremely vascular tumours in order to block the arteries that supply the tumour. This helps to decrease blood loss during surgery. Microsurgery of skull base tumours is a highly technical operation. For effective imaging of essential structures, a high-power microscope with a sturdy, antivibratory base mount is required. A high-powered drill with a variety of burrs is required, since it is crucial to be able to traverse around each nerve and blood artery. Cranial nerve monitoring is a common technique in skull base surgery. Throughout the procedure, a neurophysiologist is present in the operating room and monitors the health of the different nerves on a computer system.
This improves the preservation of cranial nerves by allowing for delicate microdissection of the tumour away from the nerve. Skull base surgery success rates have continued to rise. This is due to the emergence of contemporary methods that aim to decrease the need for brain retraction and the sacrifice of normal structures in order to reach the tumour. Our surgical strategy is founded on the idea of eliminating as much tumour as feasible while preserving function.