Tumors of the head and neck touching or even extending across the base of the skull require the intervention of a multidisciplinary team of skull base surgeons, head surgeons and the head. neck, neuroradiologists and oncologists. Many tumors previously considered inoperable can now be treated with endoscopic and microsurgical techniques, which significantly reduce mortality and morbidity rates. The tumors that form in the orbit, the paranasal sinuses and the base of the skull on which the brain rests lie in sensitive areas that require expertise and skill to prevent serious lesions and disfiguring scars.
In general, surgery has the best benefits for patients with tumors at the base of the skull, especially for benign lesions. Doctors often treat malignant tumors by combining surgery, radiation and chemotherapy. Radiation, including radiosurgery or brachytherapy, helps preserve a patient's basic mental and motor functions at longer intervals than standard radiotherapy. Doctors usually reserve chemotherapy for patients with inoperable tumors. Many postoperative patients require a period of rehabilitation because of the sensitive nature of these tumors.
Serious cancers at the base of the skull often require surgical removal, but the presence of critical neurovascular structures often limits the surgical options. Specialized surgeons must identify and preserve these vital structures and often adopt multiple surgical approaches, such as transcranial-sub-temporal, transochlear, trans-transpolar, trans-maxillary and post-auricular incisions. If surgery initially proved impossible, a combination of radiation and chemotherapy could allow a surgeon to intervene later.
Due to the complex relationships between these tumors and important cerebral and vascular structures, surgeons experienced in skull base approaches and techniques invariably achieve the best results.