Skull base tumors are tumors that are located in the sinuses or tumors that extend from the brain into the sinuses. These tumors can be benign or malignant, and there are a number of types. The specific type of tumor is key in determining the right course of treatment.
Skull Base Tumor Symptoms
To begin treatment for skull base tumors, our surgeons typically suggest a tumor biopsy. This is imperative in their ability to make a specific diagnosis and determine the appropriate plan of action. Often, begin tumors are easily resected, allowing patients to return to daily life shortly after the procedure.
On the other hand, malignant tumors are usually treated with chemotherapy and/or radiation, surgery, or any combination of these. Skull base tumors are extremely serious because if they are malignant and go untreated, they can lead to death. Additionally, even benign tumors can grow to large sizes, invading the orbital cavities and brain, causing damage to those areas. This can lead irreversible vision loss and brain impairment.
Some skull base tumors originate from exposure to environmental toxins, while others are caused by a patient’s genetic predisposition to tumor growth. Concerning symptoms that may suggest a skull base tumor include:
- Recent onset bleeding from one side of the nose
- Newly onset nasal obstruction on one side of the nose
- Facial pressure or headaches on one side of the face
- New loss of smell
- Double vision
- Bulging/swelling eyes
Skull Base Tumor Treatment
If you have signs or symptoms of a sinus or skull base tumor it is critical to consult a Rhinologist immediately for an accurate diagnosis and treatment plan. The initial evaluation will consist of a nasal endoscopy (looking inside the nose with a small camera) to determine if a sinus or skull base tumor is present. If a tumor is noted, a CT scan and MRI of the sinuses and skull base will be performed to assess the extent, invasiveness, proximity to critical neurovascular structures, and vascularity of the neoplasm. Next, a small biopsy can be performed in the office if the tumor is not particularly vascular to determine the specific subtype.
Depending on the specific tumor subtype, and if it is malignant or benign, a treatment plan is created. If the tumor is appropriate for surgical resection a minimally invasive endoscopic approach through the nostril openings is performed. The principles used for minimally invasive endoscopic sinus surgery are applied to sinus tumor resection with a critical emphasis on negative tumor margins while preserving important adjacent neurovascular structures. If the tumor is extending from the sinus into the skull base or from the skull base into the sinus, an endoscopic anterior skull base resection may be indicated. These approaches are both done through the nose without any visible scars or incisions.
There are very few Rhinologists in the world trained to perform this complex operation. Fortunately, our sinus surgeons have experience in these procedures. For certain malignant sinus tumors, postoperative radiation treatment may be required to ensure negative margins. The key is choosing an approach tailored to the severity and specific type of sinus tumor you have.
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