Page Summary
- Skull base healing requires additional precautions compared with routine sinus surgery.
- Avoid straining, heavy lifting and other activities that markedly increase pressure until cleared.
- Do not fly or use CPAP until your surgeon allows it.
- Clear nasal drainage, severe headache, fever or new visual or neurological symptoms should be reported promptly.
Recovery after skull base surgery varies from person to person. It depends on what was treated, such as endoscopic CSF leak repair or surgery for tumors near the skull base, and on whether a cerebrospinal fluid (CSF) leak was present or repaired during surgery. Here's a general picture.
In the hospital
You'll be monitored closely for the first day or more. This includes checks on your vision, how alert you are, and any nose drainage. These checks are a routine part of postoperative care.
The first weeks at home
Feeling tired is common. Allow yourself adequate time to rest. You may be asked to avoid bending forward, lifting heavy things, and straining for a period of time, as these can raise pressure in ways that slow healing.
How long these restrictions last depends on your surgery. If there was no CSF leak and no skull base repair was needed, they are often brief. If a CSF leak was repaired, they usually last longer; see What to Expect After CSF Leak Repair. Your surgical team will tell you what applies to you.
Your surgeon may prescribe a steroid (budesonide/Pulmicort) nasal rinse to help the skull base repair heal and reduce crusting. Use it only as instructed by your surgical team.
Flying and CPAP
Do not fly until your surgical team has cleared you to do so. Changes in air pressure during flight can affect healing at the skull base.
If you use a CPAP machine for sleep apnea, do not resume it until your surgical team has cleared you. CPAP pushes air under pressure through the nose, which can interfere with healing of the skull base repair.
When no CSF leak was present or repaired, this waiting period may be short.
Follow-up care
You'll have regular follow-up visits. These often include a nose exam to check healing, and imaging when needed to make sure things are going well.
Contact your surgical team promptly if you notice: clear fluid dripping from your nose, a severe headache, fever, vision changes, or a stiff neck.