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What are Skull base tumors?

Skull base tumors, also known as cranial base tumors, can often be asymptomatic (without symptoms) until they compromise neighboring structures, so they are often found at advanced stages.

Our approach

Northwell Health Cancer Institute is a leader in the treatment of skull base tumors. If you have been diagnosed with a skull base tumor, your doctors will explain all your options and create a treatment plan tailored to your specific needs and goals. You will have access to state-of-the-art diagnostics and treatments including advanced neuroradiological tests, minimally invasive microsurgery and stereotactic radiosurgery.

You will be cared for by a multidisciplinary team of specialists, including:

  • Skull base neurosurgeons
  • Otolaryngologists
  • Head and neck surgeons
  • Reconstructive surgeons
  • Neuro-oncologists
  • Neuroradiologists
  • Interventional neuroradiologists
  • Radiation oncologists
  • Medical oncologists
  • Endocrinologists
  • Anesthesiologists

Because every skull base tumors diagnosis is unique, the physicians providing your treatment will meet once a week to share ideas and will review every step of your care. Convenience and personalized care are also given prime importance throughout your treatment.

Research at Northwell

As part of your skull base tumor treatment plan, you also may have opportunities to participate in clinical trials. These trials study new chemotherapy drugs, radiation technologies and surgical approaches. While not every patient is a candidate for clinical trials, your care team will work with you to determine eligibility. Learn more about clinical trials at Northwell Health.

Symptoms

Symptoms are often dictated by the size and location of the tumor in the skull base and by nearby structures. 

Tumors of the nasal cavity:

  • Nasal congestion
  • Epistaxis (bloody nose)
  • Anosmia (inability to smell)
  • One-sided otitis media (fluid in the middle ear behind the ear drum)

Tumors of the front skull base:

  • Diplopia (double vision)
  • Proptosis (bulging of the eyeball)
  • Epiphora (drooping of the lower lid with eye drying)
  • Vision loss

Tumors of the angle between the brainstem and the cerebellum or tumors of the two small lobes below and behind the cerebrum:

  • Imbalance (vertigo)
  • Pulsatile tinnitus (ringing in the ears in time with the pulse)
  • Asymmetric hearing loss (one ear with greater hearing loss than the other)
  • Otorrhea (draining ear)
  • Vague headache
  • Facial twitching or numbness
  • The hearing loss involved can either be conductive (due to disturbance of the small bones conducting sound from the ear drum to the inner ear) or high or low frequency sensorineural (when the inner ear nerve produces nerve impulses the brain interprets as sound), depending on the location and type of the tumor

Tumors at the back of the skull base near the lower brainstem or jugular foramen:

  • Deficits of the lower cranial nerves controlling sensation in the back of the throat, voice box, neck muscles and tongue movement

Tumors that erode into the ptyregomaxillary space (a space where the internal muscles closing the jaw attach to the skull base), epidural space (space between the skull and the outer tough covering of the brain) or brain tissue itself:

  • Headaches
  • Cranial neuropathies (disease or non-function of the twelve large, paired nerves exiting the base of the brain)
  • Frontal lobe symptoms such as alterations in personality

There are also some tumors that are identified incidentally on a CT (CAT) scan or MRI a result of a generalized complaint of headache.

Diagnosis

  • Biopsy—A procedure to remove a sample of suspicious cells for laboratory testing. In the lab, specially trained pathologists examine the cells under microscopes to determine whether cancer cells are present.
  • Obtaining more detailed imaging—Your doctor may recommend imaging tests to help visualize your skull base tumor and determine whether it has spread beyond the skull base. Tests may include an MRI or CT (CAT) scan.

Treatment types

After you receive a diagnosis of skull base tumors, your doctor will develop a treatment plan tailored to your needs. Treatment usually involves surgery followed by radiation therapy. The goal of surgery is to remove as much of the tumor as possible without harming nearby healthy tissue or causing new problems. Complete resection may not be an option if it's near critical structures, such as the carotid artery. Endoscopic surgery as well as traditional approaches may be needed or used together to remove as much of the tumor as possible at the lowest risk possible. Surgery is usually followed by radiation therapy to kill any remaining cancer cells and help prevent recurrence.

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