Common diseases involving the skull base include pituitary tumors, skull base invasion by nasopharyngeal carcinoma, middle ear cancer, extensive otitis media, and skull base invasion by sinus malignancies; rare diseases include jugular vein bullae, chordoma, and auditory neuroma, all of which are serious life-threatening diseases. Skull base surgery used to be considered off-limits. With the development of medical facilities and improvement of technology, it has become possible to reach the skull base via the ear, nose and pharynx route to remove lesions and is increasingly playing an important role in improving the quality of survival and prolonging the life of patients.
Clinical manifestations (1) Pituitary tumor: Common symptoms include headache, decreased vision, and reduced visual field. According to different tumor staging, amenorrhea, lactation, early menopause, infertility; male hypogonadism; rapid growth, extremity hypertrophy, i.e. thickening of fingers, toes, nose tip, etc.; centripetal obesity, intractable hypertension, etc. respectively.
(2) Malignant tumor invading skull base: common symptoms may include prolonged bloody nose, nasal congestion, painless and rapidly growing mass in the neck, headache, pus and blood in the ear, gradually increasing deafness and vertigo; corresponding cranial nerve paralysis according to the invasion site of tumor, such as distorted mouth and eyes, difficulty in opening mouth, difficulty in swallowing, etc.
(3) Severe and widespread otitis media: pus and foul odor in the ear, severe hearing loss or accompanied by vertigo, facial paralysis, headache, fever, etc.
1.Harm: Lesions involving the skull base can be fatal regardless of malignancy, benign tumor or inflammation.
2.Clinical diagnosis: Firstly, you should go to ENT clinic for detailed specialist examination and relevant laboratory tests to determine the diagnosis.
3.Treatment principle: The treatment plan is decided according to the condition (invasion site, benign and malignant degree, acute and chronic degree and other factors).
As a mature technique, transnasal endoscopic pterygoid sinus approach pituitary tumor surgery has been performed for several patients to completely remove the tumor without craniotomy, incisionless, minimally invasive and short hospital stay, which is very popular among patients.