Skull Base Tumors

The skull base is the narrow region that forms the junction from the intracranial space and the adjacent structures in the face, neck and ear. The anterior skull base is the thin layer of bone that forms the roof of the eye sockets and the sinus and nasal cavities. Above it lies the brain, its bathing spinal fluid, and a surrounding sack called the dura. Ailments affecting these regions include tumors of the nose, sinuses, orbit, or those arising from the intracranial structures themselves. Additional conditions affecting the area are persistent leaks of spinal fluid that may present spontaneously or after trauma or surgery. Such leakages may be on just one side of the nose or both and often result in a headache and a salty or metallic taste in the back of the throat. These conditions deserve urgent medical attention as persistent leaks can lead to infections such as meningitis, which can be life threatening.

In the central skull base, tumors affecting the pituitary gland or surrounding structures may produce hormonal abnormalities and may also impact vision. Tumors of the lateral skull base include those affecting the ear and the temporal bone as well as the nerves coursing through the temporal bone (nerve that provides facial movement as well as the hearing and balance nerves).

Our skull base team includes representatives from head and neck surgery, neuro-otology, neurosurgery, radiation and medical oncology, radiology, and pathology. All members are proficient in diagnosing and treating these complex conditions. For tumors of the pituitary gland and anterior skull base, often it is possible to remove them using small endoscopes that are introduced through the nose, avoiding external facial incisions. For larger tumors as well as those affecting the ear or the nerves going through the inner ear, external incisions are required to allow for such tumors to be removed safely.

Some tumors are managed by simply observing them, occasionally repeating scans to monitor for tumor growth, while others may be treated with radiation therapy, either after or instead of surgery. Because any approach can have potential advantages and disadvantages, it is important to talk to your physician to find which approach is right for you.