Ho Chi Minh City University of Medicine and Pharmacy Hospital has just successfully performed surgery on patient D.T.D (57 years old, residing in Khanh Hoa). The patient had his first surgery in 2020 with a diagnosis of pituitary tumor invading the middle skull base, bilateral cavernous sinuses, and posterior cranial fossa. The patient underwent endoscopic surgery to remove most of the lesions in the middle skull base area, releasing previously compressed nerve structures such as the optic nerve and brainstem. After surgery, the patient was continuously monitored and examined for MRI.
Recently, the tumor progressed, invading more into the posterior cranial fossa, cavernous sinus and bilateral temporal fossa, and lower cranial nerves, causing symptoms of headache, dizziness, and tinnitus.
Common symptoms of skull base tumors are headache and blurred vision.
The patient was indicated for endoscopic and microsurgery to remove the entire lesion and reconstruct the skull base invaded by the tumor. The surgery lasted 4 hours, after which the patient will be monitored post-operatively to rule out complications.
After surgery, the patient was stable, alert, headache symptoms were significantly reduced, there was no cranial nerve damage, and no postoperative nasal cerebrospinal fluid leakage.
Combined microendoscopy and microsurgery in the treatment of skull base tumors
According to Master - Doctor Pham Thanh Binh, Department of Neurosurgery, University of Medicine and Pharmacy Hospital, Ho Chi Minh City, for large, complex skull base lesions that extend above and below the skull base, approaching the tumor with both microsurgery and microsurgery helps doctors optimize the viewing angle, approach the lesion from many directions to remove the maximum amount of damage, while increasing the safety of the patient. The incision is small, has little effect on the patient's nerves and movement, can remove all damaged tissue, the surgery time is about 3-4 hours, and causes little damage to healthy tissue... Immediately after surgery, the patient can walk and eat normally.
Endoscopic surgery through the nose and sinuses to remove skull base lesions is a new method that is increasingly being developed and expanded to access many difficult lesions that were previously inoperable.
Doctors perform microendoscopy and microsurgery to treat complex skull base tumors
What is skull base tumor?
Dr. Nguyen Minh Anh, Head of the Department of Neurosurgery at the University of Medicine and Pharmacy Hospital in Ho Chi Minh City, said that there are many different types of skull base tumors that develop at the base of the skull, which is the junction between the brain above and the subcerebral structures below (nasal sinus system, eye socket, middle cranial fossa, posterior cranial fossa). Common skull base tumors include: meningiomas, olfactory neuroblastomas, pituitary tumors, chordomas, craniopharyngiomas, bone and cartilage tumors, and cancers of the paranasal sinuses.
Skull base tumors can include benign or malignant tumors that have metastasized from elsewhere. Worldwide, the incidence of this type of tumor is about 6.2/100,000 people per year, but in Vietnam there are no specific figures.
Symptom
Symptoms of skull base tumors are often very diverse, depending on the size, specific location, and level of invasion of the tumors to surrounding structures. Patients are often only detected during health screening. Common manifestations of the disease may include nerve compression causing headaches, blurred vision, double vision, difficulty swallowing or choking when eating and drinking, numbness in the face on one or both sides, progressive numbness and weakness of the limbs over time; endocrine disorders due to hypothalamic-pituitary failure causing fatigue, poor appetite, weight loss, frequent urination; lesions in the low area below the skull base causing nasal congestion, nosebleeds, loss of smell, etc.
At the training program "Combining microendoscopy and microsurgery to treat complex skull base tumors" recently held at the University of Medicine and Pharmacy Hospital in Ho Chi Minh City, doctors from the Department of Neurosurgery shared about this technique, demonstrated surgery and reported live for colleagues to follow, discuss and share experiences, contributing to improving the effectiveness of treatment for patients with complex skull base tumors.
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