Skull Base Surgery Cost in Bangalore

Skull base surgery is recommended to treat the following medical conditions

• Cysts that are present since the time of birth
• Growths occurring as a result of infections
• Pituitary tumours
• Chordomas - type of bone cancer in malignant form
• Trigeminal neuralgia - a condition of the trigeminal nerve of the brain which results in chronic pain
• Craniopharyngiomas
• Craniosynostosis - a birth defect associated with the skull
• Cerebrospinal fluid fistulas - a condition associated with leakage of cerebral spinal fluid through the skull bone
• Cerebral aneurysm
• Arteriovenous malformations - a medical condition in which the arteries and veins form an abnormal connection that circumvents the capillary system

Possible symptoms of any abnormality in the base of the skull are

• Facial pain
• Headache
• Dizziness
• Visual problems
• Numbness
• Weakness of the face
• Hearing loss or ringing in the ears
• Nasal congestion or frequent sinus infections

Since the skull base area cannot be examined with the naked eye, the exams become an important part of the prognosis. The doctor will suggest the following before the surgery

• Brain imaging tests like MRIs, MRAs, PETs, and CTs are scans which show inside of the skull and help to visually identify if there is any need for further invasive procedures
• Biopsy to check for any cancerous growth. 
• Physical exams like testing the patient’s balance, checking the cranial nerves for hampered reactions, checking dips in muscle activity, testing for blurry vision and hearing ability.

During surgery, the patient is usually put under general anaesthesia for around 24 hours. The patient is usually kept on a heating blanket positioned over an alternating pressure air mattress as the procedure is an extensive one.

The patient’s blood pressure is intentionally kept abnormally low, especially when the main blood vessel, the petrous carotid, is dissected. Usually, past experience with bleeding during surgery will ensure that doctors start fresh frozen plasma and platelet infusions after the patient has gone through at least 4 full units of blood. This practice is usually standard procedure, and has been shown to prevent potentially deadly intracranial bleeding during and after the surgery.

Minimally-invasive or Endoscopic skull base requires a small cut in the nose through which removal of growths by a neurosurgeon is made possible. The neurosurgeon uses an endoscope, which is a very small, very thin tube with a light attached at the front. The operating team usually takes the help of an MRI to make sure that all of the growth has been removed.

Open Surgery requires a large incision, generally behind the hairline. To reach and eliminate the growth, the surgeon needs to remove parts of bone from the bottom of the skull.

Along with endoscopic and open surgery, chemotherapy and radiation therapy si also required for patients with cancerous growths in their craniums.

Post completion of the skull base surgery, the patients are monitored continuously in the ICU. Respiratory parameters have to be adequate, and the patient should be able to maintain blood oxygen saturation while incubated and spontaneously breathing.

Generally, the patients can go home in 7 to 10 days after the surgery. Complete recovery may take a couple of months or more.

Skull Base surgery is a complicated surgery. Risks associated with the surgery are:

• Pneumothorax - accumulation of air of gas in the cavity between the wall of the chest and lungs
• Cranial nerve loss or nerve loss in the skull
• Coagulopathy or inability of the blood to clot
• Stroke and death, in some cases
• Rupture of the carotid arteries 
• Bleeding inside the skull
• Cerebral edema - Fluid buildup inside the brain
• Seizure
• Hypopituitarism - reduction in pituitary gland's secretion of hormones
• Leakage of Cerebrospinal fluid
• Loss of Vision
• Dysphagia or trouble in swallowing
• Hoarseness or unusual alterations of voice