Endoscopic Skull Base Surgery: diagnosis, function and long-term planning
Endoscopic Skull Base Surgery is considered when a selected pituitary, sinonasal or skull-base lesion can be reached endonasally with acceptable neurovascular and reconstructive risk.
The safest approach depends on tumor compartment, pathology, carotid and optic relationships, cavernous-sinus involvement, hormonal status and the ability to create a watertight closure.
Who may be considered?
Specialist review may help when a central skull-base lesion requires comparison of endoscopic, open, radiation or observation strategies.
- Selected pituitary and midline skull-base tumors.
- Sinonasal tumors extending to the skull base.
- Cerebrospinal-fluid leaks requiring repair.
- A patient evaluated by coordinated skull-base specialists.
What the specialist team must confirm
Review contrast MRI and fine-cut CT DICOM, vascular imaging when relevant, formal visual fields, pituitary hormones, nasal endoscopy, pathology, neurologic examination and previous surgery or radiation.
Key points for this treatment
From multidisciplinary mapping to staged skull-base surveillance
The plan should define resection limits, pathology contingencies and postoperative endocrine, visual and nasal care.
Neurologic, endocrine and nasal recovery are monitored together
Early care checks vision, neurologic status, sodium and hormones, nasal bleeding, infection and cerebrospinal-fluid leakage.
MRI, pathology-specific care, endocrine replacement, nasal endoscopy and rehabilitation continue according to the lesion and resection result.
Risks, limits and realistic expectations
Risks include cerebrospinal-fluid leak, meningitis, bleeding, carotid injury, visual loss, cranial-nerve injury, stroke, hormonal disturbance, smell loss and need for further treatment.
Clear salty nasal drainage, severe headache, fever, neck stiffness, visual decline, confusion, marked thirst or reduced consciousness needs emergency assessment.