Skull base surgery

(Craniofacial Resection)

Tumors reaching the base of skull were historically considered inoperable and hence incurable. Due to the evolution in surgical techniques and Reconstruction methods, these tumors are at present completely removed (Craniofacial resection). This requires a team approach, including Head and Neck Surgical oncologist, Neurosurgeon and Plastic surgeon to remove the skull base tumors safely and reconstruct in functional and esthetic manner.

Why cancer is so dangerous at the skull base?

Tumours/Cancers arising in the Ear canal, nasal cavity and Paranasal sinuses are rare. Owing to the inconspicuous location, these tumours generally present at late stages. other factors that implicated in overall poor prognosis are aggressive growth patterns, proximity to neuro-vascular structures, non-specific clinical presentation. It is very important to know the warning symptoms, so that you can visit your doctor.

Which group of people are in risk getting cancer at the skull base?

Has your family a history of skull base cancer? Then you should consider a routine check up. Smokers and Snuff tobacco users are highly at risk to be diagnosed with a type skull cancer. Another risk group are industrial workers, especially exposed to wood dust and leather.

What are the symptoms of skull cancer?

Early symptoms are vague and can mimic sinusitis (sinus infection).

Consult your doctor if you have unusual or repeated problems with your nose, eyes, ears and face

Nose:

  • one sided nasal blocks (obstruction),
  • (Chronic unilateral) permanent nasal discharge of either side of the nose,
  • Bleeding from nose (Epistaxis),
  • Loss of Smell (Anosmia)

Eyes

  • Excess watering of the eye (Epiphora),
  • Abnormal protrusion or displacement of an eye (Proptosis),
  • Double Vision (Diplopia)/ Blurred vision,
  • Loss of vision (usually a late symptom),
  • Irregular eyelid shape/ eye lid ptosis

Ears

  • Discharge & Pain from the ear of long duration,
  • Blood discharge from ear,
  • Hearing loss/ Ringing sensation in the ear (Tinnitus)

Face

  • Numbness of the upper face (Paresthesia),
  • Swelling of upper face,
  • Facial Muscle weakness (Deviation of mouth, Inability to close the eye),
  • Facial pain and Headache

When should you visit a doctor?

Anybody with the above symptoms requires careful examination. A pain free fiberoptic endoscopy procedure is used for initial examination. If any abnormal tissue is found, then biopsy is taken and sent for pathological examination.. CT scan and/or MRI Scan helps to find out the extent of the lesion.

What is the procedure after cancer has been diagnosed?

  • Consult an oncologist.
  • Treatment will be planned based on the type of cancer diagnosed and extent of disease after staging is done.
  • The standard treatment for sino-nasal and Ear malignancies is Surgery. Radiation treatment is followed by surgery, if required.

How can a family member help?

What can family member do if somebody is diagnosed with skull based cancer?

  • Consult an oncologist, as most of the time the biopsy or diagnosis is made by an ENT surgeon or Maxillofacial surgeon.
  • Re-check the diagnosis by onco-pathologist. ( Oncologist can help you in this)