Page Summary
- Some skull base conditions can be reached through the nose using an endoscope, without facial incisions.
- Not every skull base problem can be treated through the nose; the approach is selected individually.
- The operation performed depends on the location and extent of the problem.
- Depending on the condition, surgery may be performed by the rhinologist alone or together with other specialists.
Endoscopic Skull Base Surgery
The skull base is reached endoscopically through the nose to treat selected tumors, cerebrospinal fluid leaks, and other skull base conditions, without any incisions on the face.
Not every skull base problem is suitable for a transnasal approach. The safest and most appropriate route depends on the location and nature of the problem.
For a simple overview of the anatomy, see What Is the Skull Base?
Who may benefit?
People with a tumor or other skull base problem that can be reached through the nose. This is decided after careful review of your scans, and in collaboration with other specialties when needed.
How is the surgery performed?
The surgery is performed endoscopically through the nose. Specialists from other disciplines may take part depending on the type and location of the condition — neurosurgery, for example, where the problem extends to the brain or the areas next to it. Image-guided surgical navigation may be used to help identify the location precisely and protect important nerves and blood vessels nearby.
Working with other specialties
The surgery may be performed independently or together with other specialists depending on the type and location of the condition, such as neurosurgery, ophthalmology, or head and neck surgery.
Before skull base surgery
Preparation for skull base surgery follows the same practical steps as other nasal and sinus procedures, which are set out in Preparing for Nasal & Sinus Surgery. A few additional steps may apply depending on the condition:
- Additional CT or MRI scans may be obtained to plan the operation, depending on the condition.
- Planning may involve more than one specialty, so you may meet more than one doctor before the operation.
- Additional tests, such as a vision assessment or hormone blood tests, are arranged only when they are relevant to the specific condition.
- You may need to stay in hospital for monitoring after the procedure. Your surgical team will tell you how long to expect.
Recovery
Recovery time depends on the type of surgery and how extensive it is. The details and the instructions for your situation are discussed before the operation, and are explained more fully on the Recovery After Skull Base Surgery page.
Smoking and surgery
Stopping smoking is strongly recommended for at least 4 weeks before surgery and 4 weeks afterward. Smoking increases the risk of breathing and anesthesia-related complications, infection, and delayed healing. If your surgery is sooner, stopping now is still beneficial.