A skull base surgery is recommended to the patients suffering from the following medical ailments:

•   A birth defect in the skull known as Craniosynostosis
•   Trigeminal Neuralgia – A condition in the trigeminal nerve that causes chronic pain to the patient• Cerebral aneurysm
•   Craniopharyngiomas
•   Chordomas – a kind of bone cancer in a malignant form
•   Pituitary Tumours
•     Cysts present in the brain from the time of birth
•   An unexpected growth occurring as a result of some infection
•   Arteriovenous malformations – the arteries and veins create an abnormal connection that tends to circumvent the capillary system

Before undergoing a skull base surgery, there are certain medical tests and exams that play a crucial role in the prognosis of cranial base surgery as it cannot be examined with the naked eye. Usually, your doctor will recommend the following tests before planning your surgery:

•   A biopsy is done to check for any cancerous growth in the area
•   The doctor’s team will also conduct a physical exam to test the patient’s balance, cranial nerves for any hampered reactions dips in muscle activity and a test for blurred vision and hearing ability 
•   A series of brain imaging tests including CT scans, MRIs, PETs, MRAs to clearly see the inside of the skull and identify the need for invasive or minimally invasive spine surgery.

Skull base surgery is major surgery, the first step of the surgery is giving the patient general anesthesia for about 24 hours. The patient is kept on a heating blanket that is positioned over an alternating pressure air mattress for additional comfort. When the petrous carotid, the main blood vessel is dissected, the patient’s blood pressure is purposely kept abnormally low. As many patients experienced bleeding during surgery, doctors today start fresh frozen plasma and platelet infusions once the patient has gone through 4 units of blood. This method has now become a procedure and has proved to prevent the potentially fatal intracranial bleeding during and post the surgery.

•   For an endoscopic surgery o skull base surgery, the neurosurgeon makes a small cut in the nose through which the extra growth removal is possible. Then a thin tube (endoscope) with a light in the front is used to guide the surgeon towards the growth.
•   Before finishing the surgery, the team uses MRI scans to make sure that all the growth has been properly removed.
•   In the case of open surgery, the surgeon will make a large incision behind the hairline. In order to clearly reach the growth and eliminate it properly, the surgeon will have to remove parts of the bone from the bottom of the skull.
•   These are then reattached after the removal of abnormal growth from the skull base. Apart from endoscopic and open surgical procedures, many surgeons also recommend chemotherapy and radiation to patients with cancerous growths in their craniums.

Post skull cancer spine surgery, the patient has moved the ICU and kept under observation. During this stage, the doctors take care of the patient as the patient’s respiratory parameters need to be adequate and the patient should be able to maintain his blood oxygen saturation while being intubated and spontaneously breathing. Usually, the patients can go home after 7 to 10 days, once all their reports are fine. However, It might take a few months to get completely after this kind of surgery, and therefore, patients are recommended to take good care of themselves and avoid heavy activities.

After skull base surgery, you will be closely cared for by your medical team as skull base surgery is a highly complicated procedure and thus, brings with it a large number of risks and complications for the patient. You will be told about all the risks associated with the surgery beforehand so that you can make a well-informed decision. Some commonly known risks include:

•   Unusual alterations in voice or hoarseness
•   Hypopituitarism, reduction in the secretion of hormones in the pituitary gland
•   Rupturing of the carotid arteries
•   Loss of vision
•   Cerebrospinal fluid leakage
•   The build-up of fluid in the brain- cerebral
•   Trouble in swallowing
•   Cranial nerve loss, also known as nerve loss in the skull
•   Pneumothorax – a medical condition in which air or gas gets accumulated in the cavity between the lungs and chest
•   Bleeding inside the skull
•   The Inability of blood to clot, medically known as Coagulopathy
•   In rare cases, stroke, and sudden death
•   Seizures