Skull Base Conditions

Skull base pathology involves diseases affecting the bottom part of the skull, which supports the brain and separates it from the sinuses and facial structures. These conditions can arise inside the skull (intracranial), within the bones of the skull base, or outside the skull (extracranial).

Skull base conditions (pathology) refers to diseases that affect the area at the bottom of the skull, which separates the brain from the sinuses and facial structures.

Common conditions include tumours such as pituitary tumours, encephaloceles, congenital tumours, chordomas, craniopharyngiomas, and cerebrospinal fluid leaks. Traditionally, these conditions were treated with open transcranial surgery, where part of the skull is removed for access. However, newer, minimally invasive techniques using an endoscope through the nose and sinuses are now commonly used. Treatment often involves a multidisciplinary team, including otolaryngologists (ENT surgeons), neurosurgeons, and oculoplastic surgeons.

Factors, Symptoms, Diagnosing, and Beyond:

What are the common symptoms of skull base pathologies?

Common symptoms of skull base pathology include persistent headaches, nasal congestion or blockage, recurrent nosebleeds, cerebrospinal fluid (CSF) leaks, vision changes like blurred or double vision, facial pain or numbness, hearing loss, and balance issues. These symptoms arise from the pressure or growth of tumours affecting surrounding structures in the skull base.

How are skull base pathologies diagnosed by an ENT specialist?

An ENT specialist diagnoses skull base conditions using a combination of methods but these can also be diagnosed by other specialists. Initially, a detailed medical history and head and neck examination are performed. Endoscopic evaluation, often performed through the nasal passages, allows direct visualization of the affected areas. Imaging tests such as CT or MRI are crucial for assessing the extent of the condition. Bloodwork may also be necessary to help assess impact of condition. If a tumour or abnormality is detected, a biopsy may be performed to help dictate treatment. These diagnostic tools help the multidisciplinary team develop an appropriate treatment plan.

What are the best treatment options for skull base pathology conditions?

Treatment for skull base pathology typically involves minimally invasive endoscopic surgery or, in more complex cases, open surgery to remove tumours or repair damage. For malignant tumours, radiation therapy or chemotherapy may be used alongside surgery to target and destroy cancerous cells. The specific approach depends on the type and extent of the condition.