A Deep Dive into Endoscopic Anterior Skull Base Surgery

A Deep Dive into Endoscopic Anterior Skull Base Surgery

Overview

The cranium bones, which encircle the brain, are made of bones and cartilage, which together make up the skull. Together with the eye socket, nasal cavity roof, certain sinuses, and the bones around the inner ear, the five bones that make up the base of the skull also constitute the eye socket. The spinal cord, many blood arteries, and nerves all travel via various apertures in the densely packed and intricate base of the skull.

Skull base surgery can be used to remove both cancerous and benign growths and abnormalities on the underside of the brain, or the first few vertebrae of the spinal column. Due to the difficulty in visibility and accessibility in this area, minimally invasive endoscopic procedures may be used for skull base surgery. The field of Endoscopic Anterior Skull Base Surgery has grown over the past ten years, now including the treatment of tumours of the anterior cranial base. The only method to remove growths in this part of the body prior to the development of endoscopic skull base surgery was to create an incision in the skull. This kind of surgery could be required in certain situations.

What is Endoscopic Skull Base Surgery?

With the use of endoscopes, endoscopic anterior skull base surgery is a novel approach that allows doctors to reach and treat disorders at the base of the skull. Usually, a little incision is sufficient for this kind of surgery. In order to enable a neurosurgeon to remove a growth using an endoscope—a thin, illuminated tube—they may create a tiny incision within the nose. To ensure that every growth has been eliminated, the surgical specialists may use magnetic resonance imaging (MRI), a form of imaging test that uses magnets and a computer to take a picture of the base of the skull. Surgeons go into the nasal cavity to address tumours or anomalies located at the anterior base of the skull using specialised devices and high-definition cameras.

This method is recommended over conventional surgery for a number of reasons, including:

• It requires less time
• It enables surgery on big tumours and in previously unreachable places
• It does not leave a single facial scar
• It enhances functional outcomes
• It involves less time spent in the hospital.

When is it Required?

In cases when there are tumours, lesions, or anomalies at the base of the skull, the choice to have endoscopic anterior skull base surgery may arise.  Tumours that could not previously be treated can now be treated. This surgery is often required to effectively treat conditions including:

• Pituitary tumours
• Meningiomas
• Clivus and odontoid
• Cerebrospinal fluid fistulas
• Tumour resection in the anterior, middle, and pterygomaxillary fossa.

To treat these conditions, precise access is necessary with the least amount of harm to the surrounding tissues and systems. This technique’s less invasiveness speeds up healing and lowers the risk of problems following surgery.

What does it involve?

A highly competent surgical team, advanced imaging methods, and thorough planning are required for Endoscopic Anterior Skull Base Surgery. With this minimally invasive procedure, the nasal cavity may be used as an endoscopic route without necessitating a skull opening. In order to correctly see the lesion and surrounding tissues, a thorough preoperative examination is conducted, which may include imaging investigations, such as CT and MRI scans. Pre-operative assessments that include blood tests and medication modifications may also be performed on patients. In order to remove the disease and preserve important anatomical features, the surgeon uses endoscopic tools to go through the nasal passageways during surgery.

Procedure

A multidisciplinary team consisting of an otolaryngologist (an expert in treating the ears, nose, and throat) and a neurosurgeon performs endoscopic skull base surgery. In order for the neurosurgeon to use the endoscope for surgery, the ENT surgeon creates a tiny incision within the nasal cavity. Sometimes, the process consists of two different processes performed on different days, the first of which is the nasal “exposure” and the second is the excision of the tumour. Surgeons use high-definition cameras to guide them through complex nasal passageways in order to access lesions or tumours. They carefully remove the diseases while protecting the surrounding structures using specialised equipment.

Although more complicated surgeries might take up to six hours to perform, most procedures are finished in two to four hours. The day following the surgery, most patients are able to get out of the bed on their own.

Post-Operative Care

In order to ensure comfortable recovery after surgery, patients need specialised care. This can include a brief hospital stay for pain monitoring and treatment. Most patients need to spend several days in the ward for monitoring and recovery and at least one day in the critical care unit. Instructions for caring for the nose, food suggestions, and limitations on physical activity are given to patients following surgery. The medical team may monitor the patient’s healing, treat any issues that arise, and assist in their rehabilitation with routine follow-up sessions.

Patients must return every 14 days for an endoscopic inspection of the nasal cavity to monitor the healing process, which usually takes 3 to 4 months. A second drain (lumbar drain) is sometimes implanted in the spine to help with nasal healing and avoid brain fluid leaks.

Recovery

Your nose will recover entirely in 6 to 8 weeks. After surgery, patients could feel a little discomfort or have a nasal discharge. Generally, pain treatment and limited activity are recommended. After surgery, you can feel tired for seven to ten days. The healthcare team can keep an eye on patients’ progress, address any problems, and help them through the healing process with routine follow-ups. For the first two days following your discharge from the hospital, you should minimise activities like walking and stair climbing.

Give yourself four to six weeks off from any intense activity. You might somewhat up your activity level gradually. One effective exercise for recovery is walking. Gradually increase the distance by starting with shorter strolls. Physical, occupational, and/or speech therapists may be recommended by a doctor. They may assist you with resolving any issues you may have with speech, swallowing, daily living skills, strength, mobility, and balance.

Why Choose Apollo Hospitals, Karnataka?

Apollo Hospitals, Karnataka, which is well-known for providing exceptional treatment, has medical advancements at the heart of its goal to provide top-notch healthcare services. Apollo Hospitals provides advanced endoscopic anterior skull base surgery, backed by modern facilities, a diverse team of professionals, and a dedication to patient-centric care. Over the past several years, Apollo Hospitals have been striving for excellence in providing world-class treatment in the area of Endoscopic Anterior Skull Base Surgery. To consult with our doctors, contact our team today.