Understanding Skull Base Tumors: Diagnosis, Symptoms, and Surgical Treatment

Jump To Section

• What is Skull Base Surgery?
• Types of Skull Base Tumors
• Symptoms and Complications
• Malignant Skull Base Tumors
• Degenerative Skull Base Diseases
• Importance of Medical Second Opinion
• Full Transcript

What is Skull Base Surgery?

Skull base surgery is a highly specialized neurosurgical field focused on treating tumors and diseases located at the delicate interface between the brain and the neck. Dr. Philip Theodosopoulos, MD, describes this area as deeply located and anatomically complex. The discipline represents a collaboration between head and neck surgery and brain surgery, targeting lesions that are not within the brain parenchyma itself but along its surrounding structures.

Types of Skull Base Tumors

Skull base tumors encompass a wide variety of neoplasms. Dr. Philip Theodosopoulos, MD, explains that these tumors can originate from the nerves surrounding the brain, the linings of the brain (meninges), or the outer surface of the brain. Common examples include pituitary adenomas, acoustic neuromas (vestibular schwannomas), and meningiomas. The list of treatable skull base tumors is extensive, including over 50 different types that arise from structures like the paranasal sinuses and the blood vessels at the base of the skull.

Dr. Anton Titov, MD, notes in the interview that while many are benign, their location makes them particularly debilitating for patients.

Symptoms and Complications

The symptoms of a skull base tumor are directly related to its effect on critical neurological structures. As Dr. Philip Theodosopoulos, MD, details, these tumors can damage the brainstem and the cranial nerves. This damage leads to functional problems like facial movement issues, eyesight problems, and swallowing difficulties. A major complication is the obstruction of cerebrospinal fluid (CSF) flow within the brain, which can cause severe headaches and increased intracranial pressure.

Malignant Skull Base Tumors

Although many skull base tumors are benign, a subset are malignant and represent some of the most challenging cases to treat. Dr. Philip Theodosopoulos, MD, highlights true malignancies such as nasopharyngeal carcinomas and sinonasal malignancies. These cancers often originate in the paranasal sinuses or the face and then extend into the cranial cavity. Their invasive nature and location make their treatment particularly complex and require a multidisciplinary approach.

Degenerative Skull Base Diseases

It is not only tumors that skull base neurosurgeons treat. Dr. Philip Theodosopoulos, MD, clarifies that the field also addresses degenerative processes. These non-cancerous diseases can cause abnormal bone thickening along the base of the skull. This thickening can obstruct the cranial nerves as they exit the skull through small holes called foramina. It can also compromise the flow of arteries that supply the brain with blood, leading to significant neurological symptoms.

Importance of Medical Second Opinion

Given the complexity and rarity of these conditions, obtaining a medical second opinion is crucial. Dr. Anton Titov, MD, discusses how a second opinion confirms that a skull base tumor diagnosis is both correct and complete. Furthermore, it helps patients and their families choose the absolute best treatment strategy, whether it involves surgery, radiation, or other modalities. Dr. Philip Theodosopoulos, MD, supports this view, encouraging patients to seek a second opinion to be confident they are receiving optimal care for their specific condition.

Full Transcript

Skull base tumor surgery treats neoplasms and degenerative diseases. These diseases affect the juncture between neck and head. Leading skull base neurosurgeon explains the challenges that skull base surgeons face. This is a deeply located and delicate anatomical area.

Skull base tumor surgery.

Dr. Philip Theodosopoulos, MD: Skull base tumor types and facts.

Dr. Anton Titov, MD: Video interview with leading expert in skull base neurosurgery. Treatment for skull base tumors by world-class neurosurgeon.

Tumors of the skull base originate from brain parenchyma. In extensive interview we talk about specific diseases that skull base tumor neurosurgeon treats. They also arise along the nerves that surround the brain.

Skull base tumors happen from arteries and veins on the base of the skull. Nasopharyngeal carcinomas are also an example of skull base tumors.

Dr. Philip Theodosopoulos, MD: Skull base tumor surgery recovery takes several months. Sinonasal malignancy appears from the paranasal sinuses.

Symptoms of skull base tumors relate to obstruction the flow of cerebrospinal fluid in the brain. Signs include headaches, cranial nerve malfunction, eyesight problems and swallowing problems.

Dr. Anton Titov, MD: Medical second opinion confirms that skull base tumor diagnosis is correct and complete. Medical second opinion also helps to choose the best treatment for skull base tumor.

Dr. Philip Theodosopoulos, MD: Seek medical second opinion on skull base tumor and be confident that your treatment is the best.

Skull base tumor surgery.

Dr. Anton Titov, MD: You hold the position of Director of Skull Base Tumor Program at University of California San Francisco.

Could you please define what types of lesions are treated by the skull base neurosurgeons? Please talk about additional neurosurgical treatments that you focus on in your practice.

Dr. Philip Theodosopoulos, MD: Sure. The skull base is an interface between the head and neck surgery, and brain surgery. Brain tumors often arise from within the brain parenchyma. Skull base tumors arise along the nerves that surround the brain.

Skull base tumors also arise along the linings of the brain. Tumors also arise along the outer surface of the brain.

Skull base tumors also arise from other anatomical structures around the base of the skull. This is the paranasal sinuses and arteries and veins on the base of the skull.

Dr. Anton Titov, MD: These lesions are in general benign in their rate of growth. But skull base tumors are debilitating for patients. Because they involve important parts of the brain.

Skull base tumors can damage the brainstem and cranial nerves. Cranial nerves move all the various things in our face and eyes. Cranial nerves also make swallowing possible.

Skull base tumors also can obstruct the flow of cerebrospinal fluid in the brain. There is a subset of skull base tumors that are malignant.

True malignancies arise from the face and paranasal sinuses. They extend into the brain. Such skull base tumors are truly the toughest tumors to treat.

It is a big broad spectrum of diseases and tumors. I say that it is diseases and not just tumors. Because there are some degenerative processes.

They are diseases that involve the base of the skull. Such degenerative diseases thicken the bone. They obstruct cranial nerves.

Dr. Philip Theodosopoulos, MD: Cranial nerves go out of the skull through foramina, the holes of the skull. Skull base diseases also can obstruct flow of the arteries that supply the brain.

It is not only the tumors. Skull base lesions also include degenerative masses. They arise from the degenerative processes in joints and bony surface along the base of the skull.

Skull base tumors and diseases are rare but they happen. This is a spectrum of diseases that we treat along the base of the skull.

Dr. Anton Titov, MD: The names of tumors that skull base neurosurgeon treats are these. Pituitary adenomas, acoustic neuromas, meningiomas.

These skull base tumors are the most common tumors. Nasopharyngeal carcinomas are the malignant tumors that skull base neurosurgeon treats.

But the list of tumors that skull base neurosurgeons treat includes 50 or more different types of tumors.

Dr. Philip Theodosopoulos, MD: Skull base tumor surgery. Video interview with leading expert in skull base neurosurgery. What lesions skull base neurosurgeons treat? Benign malignant tumors.