SKULL BASE SURGERY
The skull consists of bones and cartilage that form the face and the cranium that encircles the brain. The skull base is an , intricate region with numerous openings through which the spinal cord, blood vessels, and cranial nerves pass through. It is the base, upon which the brain rests. Skull base surgery is predominantly performed to remove a tumour that is attached to the skull base. The difficulty of skull base surgery is accessing these areas without cutting through the skull and retracting the brain. The objective is to reach and operate on these problematic areas with minimal disturbance on the brain. Thankfully with modern minimally invasive skull base access techniques, tumours in this are can be reached with very minimal brain disturbance.
WHEN IS SKULL BASE SURGERY NECESSARY?
Skull base surgery is performed for the treatment of a variety of abnormalities and tumours. These abnormalities can include tumours such as meningioma, chordoma or craniopharyngioma, cysts that develop from birth, trigeminal neuralgia, and cerebral aneurysm surgery.
HOW IS SKULL BASE SURGERY DONE?
Following consultation with Professor Profyris and his team in Johannesburg, South Africa, a detailed plan that is customised to your specific tumour will be made. Various imaging technologies such as CT, MRI, MRA/MRV and/or angiography will be used to plan your surgical approach meticulously. Although the skull base was historically difficult to access, advancement in our understanding of anatomy and the use of medical technology has led to the development of eloquent surgical approaches to address pathology in this region. Depending on the pathology and on the exact location, Professor Profyris will use either a microscope, an exoscope or an endoscope in order to address the lesion. Often, Professor Profyris uses a combination of these visualisation technologies in order to address a particular pathology. In Johannesburg, Professor Profyris and his team have developed particular expertise in the keyhole and minimally invasive procedures available to treat abnormalities and tumours of the skull base.
VESTIBULAR SCHWANNOMA (ACCOUSTIC NEUROMA)
This is a case of a vestibular schwannoma (acoustic neuroma) operated on by Professor Profyris through a keyhole approach. The green arrows on the left hand images demonstrate the vestibular schwannoma which has been removed as can be seen by the images on the right. This patient did not suffer any facial nerve weakness.
The green arrows on the left hand images demonstrate the giant acoustic neuroma which has been removed as can be seen by the images on the right. This patient presented with multiple problems due to the giant size of the tumour. These symptoms have successfully resolved.
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FAQ
Typically, skull base surgery with Professor Profyris is not painful. The use of minimally invasive and keyhole techniques disrupts normal tissues minimally and thereby leads to significantly reduced post-operative pain.
The answer to this is highly variable. The most important aspect of skull base surgery is safety. Depending on the exact location, type and size of tumour there can be a huge variation in time. With time ranges of less than an hour to many, many hours. The use of minimally invasive approaches and careful study of your pathology through pre-operative imaging can save significant time in theatre. As a high-volume tumour practice, we have significant experience with skull base and complex skull base surgery.
Recovery is highly variable. However, the keyhole techniques that Professor Profyris utilises allow for faster recovery. Most patients are discharged from hospital after very few days and generally recover fairly quickly. Actual recovery will depend on factors such as tumour size and location. Professor Profyris will have a detailed conversation with you about this.
