The base of the skull is the foundation on which the brain rests. This is a complex anatomical region located under the brain and in front of the brain stem, behind the face.
This is one of the body’s most complex anatomical regions.
The multiple bone structures that make it up are crossed by :
- vessels that supply blood to the brain (internal carotid artery, vertebral artery, etc.),
- the brain stem, which becomes the spinal cord in the spinal canal through the foramen magnum,
- the controlling nerves :
- sense organs (sight, smell, hearing, taste), lacrimation and salivation,
- the oculomotor muscles that enable the eyeball to move,
- superficial and deep facial muscles (mimicry, mastication),
- muscles of the tongue, palate and pharynx involved in swallowing and voice,
- sensitivity of the face, cornea, nasal cavities, mouth and pharynx
The base of the skull is therefore a tangle of bone, sensory, nerve, vascular and muscular structures that are highly functional and vital for some people.
Skull base surgery treats lesions deep between the skull base and the brain, or in the skull base itself. The most common pathologies affecting the base of the skull are tumors. These tumors can be histologically “benign” (e.g. meningiomas, acoustic neurinomas, pituitary adenomas, craniopharyngiomas) or malignant (cancerous) (e.g. originating in the sinuses, bone, cartilage, ear or salivary glands).
ESTHESIONEUROBLASTOMA
CHOLESTERINE GRANULOMA
TUMORS OF THE JUGULAR FORAMEN
TUMORS OF THE CAVERNOUS SINUS
ROCK TUMORS
TUMORS OF THE ORBIT
Early diagnosis and multidisciplinary management is the key to effective treatment of these tumors.
Because of their location, injuries to the base of the skull can cause a wide range of symptoms, including visual, hearing, smell, balance and swallowing disorders, headaches, facial asymmetry, sensitivity disorders and/or facial pain, nasal obstruction, vertigo…
Cerebral CT andMRI scans are the main tests used to identify the lesion. CT scans enable precise assessment of bone structures, but lack spatial resolution for soft tissues. MRI enables precise assessment of the soft tissues, the lesion and its relationship with surrounding structures. Other tests may be ordered depending on the type and location of the suspected lesion:
– cerebral angioscan, MRI angiography and/or arteriography to assess the vascularity of the lesion, its relationship with the major vessels supplying the brain, such as the internal carotid and vertebral arteries, and the anatomy of the cerebral drainage veins, in order to preserve them as much as possible,
– an ophthalmological check-up
–an ENT check-up to assess hearing, balance and swallowing skills
–an endocrinological check-up to assess any possible repercussions of the lesion on the functioning of the pituitary gland, a small gland connected to the brain and located at the center of the skull base
etc…
- Operating microscope with integrated neuronavigation and endoscopy
- High-definition (HD) endoscope
- Ultrasonic scalpel
- Neuronavigation
- Intraoperative cranial nerve monitoring
- Intraoperative somaesthetic and motor evoked potentials
- Intraoperative CT scan being acquired
These surgeries are performed in dedicated operating theatres incorporating state-of-the-art imaging, visualization, monitoring and guidance technologies.
The department also boasts highly qualified paramedical staff.
Our common goal is to offer the best possible surgical result with the fewest side effects and maximum preservation of function.
Our department maintains close links with many neurosurgical teams abroad, and we welcome many visiting neurosurgeons from abroad to train in these techniques.