Skull base


Skull base


Although applicable to a broad spectrum of tumor, malformative and degenerative diseases, endonasal endoscopic neurosurgery techniques are currently the treatment of choice for pituitary adenomas, craniopharyngiomas and some meningiomas at the base of the skull.

This technique is only applied in certain reference hospitals in Spain. The "classic" neurosurgical approach to tumors of the skull base is performed from "inward", usually reaching tumor injury through natural corridors in the brain, as opposed to the endoscopic approach, where the brain is either above or behind the tumor, favoring less manipulation of brain tissue.

The postoperative period of these patients is more comfortable in the absence of external injuries, and hospital stays are significantly shortened on other occasions.

Pituitary adenoma

In the pituitary gland or pituitary can cause tumor processes that, although usually have a benign nature, can sometimes affect fundamental structures such as carotid arteries or optic nerves. Patients with this type of lesion should be previously evaluated by the Endocrinologist, who prescribes the corresponding hormonal study for the preoperative assessment of the patient.

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Acoustic neuroma

Vestibular schwannoma, also known as acoustic neurinoma, represents a pathology that challenges the neurosurgeon because of the technical difficulty it offers in its surgical treatment. On the other hand, it must be taken into account that it has a benign nature, which implies that its evolution after a good surgical resection is very favorable.

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Cranial base meningioma

Meningiomas are tumors that originate from the cerebral envelopes, and can be located in any area of the nervous system.

Those implanted at the base of the skull (the "seat" of the brain) present a significant management difficulty, but nowadays they can be treated safely with the great technical contribution of endoscopic surgery through the nostrils, which allows the removal of complex tumor processes in a less aggressive way for the patient.

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Advanced nasosinusal ENT surgery

Surgery of the nose and sinuses was previously performed by external incisions on the face, which produced an obvious aesthetic defect and more prolonged and annoying postoperative. Fortunately today, most nasosinusal surgical diseases can be treated only by endoscopic techniques, using the natural nasal cavity corridor. Our team has carried out multiple interventions of this type, emphasizing as a reference unit in the pathology of frontal sinus and nasosinusal tumors.

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The craniopharyngioma is a tumor located above the pituitary gland, and that in its growth can produce significant hormonal disorders. It also affects the optic nerves, so the therapeutic management of these tumors is the neurosurgical treatment, by which the objective of decompressing the optic pathways is achieved.

In Neurovist we are specialists in this type of pathologies, which intervene exclusively through endoscopic surgery through the nostrils.

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Cerebrospinal fluid fistula

At Neurovist we are experts in the treatment of cerebrospinal fluid fistula, which consists of the loss of cerebrospinal fluid through the nostrils or the ear.

They can appear after traumatisms or idiopathically, ie without any notable antecedents. This pathology responds very well to the neurosurgical treatment, which is performed minimally invasively through the nostrils only.

How is the surgery?

In endoscopic neurosurgery of the lesions of the base of the skull, access is made only through the nostrils, through which we develop in the first time a working channel that will allow us to access with comfort to the specific anatomical area in which is the pathology. The tissues of the nostrils will also be used later in the closure of the defects that we have created in the cranial base. In the second time (neurosurgical), the lesion is accessed, performing a removal with microsurgical technique.

In this type of techniques we work together the otolaryngologist specialist with the neurosurgeon, working "four hands" through both nostrils, a circumstance that requires a collaboration and exquisite rapport between both specialists.

The postoperative period is generally well tolerated by patients. In many cases we place a nasal tamponade that is maintained for some days.