What is Skull Base?

and what to expect when visiting your skull base centre

The skull base is the floor of bone separating your brain from your neck; it sits level with your nose and ears. It consists of bone, blood vessels, nerves (which help with movement and the feeling to your head and face), and other soft tissues such as the sinuses, which are air-filled holes around the nose, and the upper part of your neck. In the middle sits the brainstem, which is the bottom part of the brain where it connects to the spinal cord. This is important as most of our nerve connections run through this area and help the rest of our body with movement and sensation. The brainstem is also important as it helps us with our most basic functions such as breathing, our heart rate, sleeping and eating.

People with a skull base tumour can notice different symptoms at first, and this often relates to where the tumour has grown and what nerves and other structures have been affected. Problems that may be noticed include a feeling that the nose is permanently blocked; nosebleeds; sight loss or double vision; facial pain or numbness; hearing loss; dizziness or imbalance; facial weakness; speech difficulties and swallowing problems, and limb weakness. Some of these symptoms can be helped with treatment, and some may be preventable with treatment early on. Some patients can have headache, memory problems or changes in their personality. Rarely, these tumours can cause seizures. It is important to understand that not everyone will have some or all of these symptoms, depending on where the tumour is. Some patients will have no symptoms at all and the tumour may have been found by accident when looking for another reason.

The management of skull base tumours is complex, and many people will be involved in decisions around what treatment you need. This will include surgeons from multiple teams, radiologists (who review scans that you have had), specialist nurses, oncologists (doctors who specialise in delivery of radiotherapy treatment, even though most tumours will be benign and not cancerous) and histologists (who will review any samples that you have had taken of your tumour). These tumours can be difficult to manage because they are located near to important parts of your brain and spinal cord.

After the whole team have reviewed your scans and other information, we will discuss with you what the best options are for your treatment. This may simply be to continue watching your tumour, or it may be to consider surgery or radiotherapy. You will be able to meet all the doctors and nurses involved in your care, and they will be able to answer any questions that you or your family may have. Managing skull base tumours not only includes treatment of the tumour but also the symptoms caused by that tumour. Your centre will be able to offer specialist advice on hearing, balance, mobility, vision, speech and language therapy, so if you are worried about these do ask.