Skull Base Tumour Surgery

Skull base surgery removes tumours that grow on the floor of the skull, behind the eyes and nose or around the ear and brainstem, such as meningiomas, vestibular schwannomas (acoustic neuromas), chordomas, chondrosarcomas, craniopharyngiomas and large pituitary tumours. Access is through the nose with endoscopes or through carefully placed openings in the skull.

The aim is to remove as much tumour as is safe while preserving the nerves for sight, facial movement, hearing and swallowing that run through the region. Complete removal is not always possible or wise; a planned remnant treated with radiosurgery often gives a better quality of life.

What Skull Base Tumour Surgery involves

Planning uses high-resolution MRI, CT of the bone, angiographic sequences and tests of hearing, vision and hormones. Some very vascular tumours are embolised a day or two before. For midline tumours, ENT and neurosurgeons work together through both nostrils, opening the sphenoid sinus and the bone behind it under endoscopic view with image guidance, removing the tumour piece by piece, then sealing the defect with fat, fascia and a flap of nasal lining on its own blood supply. For tumours at the side, approaches such as retrosigmoid, translabyrinthine, pterional or orbitozygomatic craniotomy are chosen. Cranial nerves are monitored electrically throughout, and the tumour is debulked with ultrasonic aspiration before its capsule is separated from nerves and vessels under the microscope.

Who is a good candidate for Skull Base Tumour Surgery?

Decisions are made by a multidisciplinary skull base team, and observation is often a valid option.

• Growing tumours, or those causing symptoms through pressure on the brainstem, optic nerves or other cranial nerves
• Large vestibular schwannomas, generally over about 3 cm
• Chordoma and chondrosarcoma, where maximal removal followed by proton or precision radiotherapy is standard
• Pituitary tumours and craniopharyngiomas extending beyond the pituitary fossa
• When a tissue diagnosis is needed and biopsy alone is not enough

It is usually not the right choice if:

• Small, symptom-free meningiomas or schwannomas, which can be monitored with yearly MRI
• Small to medium tumours well suited to radiosurgery, particularly in older patients
• People whose general health makes a long operation unsafe
• Tumours that fully encase critical arteries, where only a partial removal is reasonable
• Prolactin-secreting pituitary tumours, which are treated with tablets first

الخيارات التقنية

• Extended endoscopic endonasal approach: No external incision; for midline tumours from the front of the skull base to the clivus.
• Retrosigmoid craniotomy: Behind the ear; may preserve hearing in vestibular schwannoma.
• Translabyrinthine approach: Through the inner ear; sacrifices hearing on that side but gives excellent exposure of the facial nerve.
• Pterional and orbitozygomatic approaches: For tumours around the optic nerves and cavernous sinus.
• Planned subtotal removal with radiosurgery: Protects nerve function when the tumour adheres to critical structures.
• Proton beam therapy: Used after surgery for chordoma and chondrosarcoma.

ماذا يحدث خلال علاجك

Operations last from 3 to over 10 hours under general anaesthetic. You spend the first night in intensive care, with frequent checks of consciousness, vision, facial movement and fluid balance. The hospital stay is typically 5 to 10 days. A lumbar drain is sometimes used for a few days to protect the repair.

الإعداد لرحلتك

Plan for 3 to 4 weeks in Istanbul. Your surgeon reviews photographs and your medical history before you book, and you meet in person the day before surgery for examination, marking and consent with a professional interpreter.

• Stop smoking and nicotine at least four weeks before and after surgery; it is the single biggest avoidable cause of wound problems
• Tell the team about every medicine and supplement you take; blood thinners, some herbal products and hormone treatment may need to be paused on your doctor's advice
• Arrange for someone to travel with you or to be reachable, and keep the first days at home free of work and lifting
• Book a changeable return flight; your surgeon confirms when you are fit to fly

التعافي والنتائج

After endonasal surgery expect nasal congestion and crusting for several weeks; do not blow your nose, strain or bend forward, and avoid flying until your surgeon clears you, often 2 to 4 weeks. After craniotomy, fatigue and headaches improve over 6 to 12 weeks. Balance rehabilitation, facial physiotherapy, eye protection or hormone replacement may be needed. MRI is done at about 3 months and then regularly for many years.

• Back to everyday activity: 6 to 12 weeks
• When results show: Pressure symptoms may ease within days; nerve recovery takes months
• How long they last: Depends on tumour type; lifelong MRI surveillance

سياسة السلامة والمخاطر والتنقيح

Risks depend heavily on the tumour type, its location and the experience of the team.

• Cerebrospinal fluid leak, with a risk of meningitis; it may need re-operation
• Facial weakness, hearing loss, double vision, or swallowing and voice problems from cranial nerve injury, temporary or permanent
• Stroke or bleeding
• Hormone deficiency or diabetes insipidus after surgery near the pituitary
• Loss of the sense of smell after some approaches
• Seizures, blood clots and chest infection
• Residual or recurrent tumour needing radiosurgery or further surgery
• Death in a small percentage of major cases

Every written proposal arranged through Clinic-Y states what the clinic covers if a correction is needed. Ask for it before you book, not after.

Cost of Skull Base Tumour Surgery in Türkiye

Clinic-Y does not publish a single price for Skull Base Tumour Surgery, because the honest figure depends on your case. What moves it:

• Approach and duration, including a two-surgeon team
• Nerve monitoring, neuronavigation and any pre-operative embolization
• Intensive care and total length of stay
• Further radiosurgery or proton therapy
• Rehabilitation and long-term MRI follow-up

Send your photographs or reports and you receive written, all-inclusive proposals from suitable teams, side by side. Reviewing your case is free.

الأسئلة المتكررة