Lateral skull base surgery refers to a range of surgical procedures targeting the area of the skull where the brain transitions to the spinal cord, involving bones of the skull and the bottom of the brain. It is a highly specialized field due to the complexity and sensitivity of this region, often requiring a multidisciplinary approach.
Technique: The technique involves accessing the lateral part of the skull base, which can be approached through various routes depending on the location of the pathology. It often requires careful dissection and removal of bone to access tumors, vascular malformations, or other pathologies while preserving neurological function and minimizing cosmetic impact.
- High-Speed Drills: To remove the bone of the skull base.
- Microsurgical Instruments: For delicate dissection around nerves and blood vessels.
- Endoscopes: For visualization in tight spaces.
- Neurosurgical Navigation Systems: To precisely localize the pathology and avoid critical structures.
- Microscopes: To magnify the operative field.
- Cranial Nerve Monitoring Equipment: To ensure the integrity of cranial nerves during surgery.
Lateral skull base surgery is complex, often involving teams including neurosurgeons, otolaryngologists, and radiologists. These operations require meticulous planning and execution due to the area’s intricate anatomy and the vital structures contained within it.
- Vestibular Schwannomas (Acoustic Neuromas): Benign tumors that develop on the balance and hearing nerves.
- Meningiomas: Typically benign tumors that form on the membranes covering the brain.
- Chordomas: Rare tumors that can occur at the base of the skull.
- Glomus Tumors: Tumors arising from the paraganglia located in the head and neck.
- Cerebrospinal Fluid Leaks: Abnormal leakages of fluid from around the brain.
- Trauma: Fractures or other injuries affecting the base of the skull.
Micro ear surgery utilizes an operating microscope and precise instruments to treat ear disorders with minimally invasive techniques. It’s indicated for conditions like chronic ear infections, cholesteatoma, and otosclerosis, and can involve procedures like stapedectomy. This approach allows for detailed ear structure visualization, enhancing surgical outcomes and recovery.