Dr. Amitabha Chanda

MBBS(Gold Medalist), MS(Gold Medalist)

MCh(Neurosurgery)

Consultant Neurosurgeon

Apollo Hospitals, Dhaka

Bangladesh

Skull Base Tumors

Left Petroclival Meningioma
A 50-year-old lady presented with headache, difficulty in walking and swallowing problems. MRI scan brain showed a large tumor in left petroclival region. It was a meningioma. Transtemporal approach was used through petrous bone and total excision of the tumor was done. The lady recovered completely.
Postoperative MRI showing no tumor
Esthesioneuroblastoma
This 14-year-old girl from Bangladesh presented with loss of smell sensation, blocking sensation in nose, nasal bleeding, headache and loss of vision. MRI showed a large tumor in brain, nasal cavity and orbit (eye socket). She was operated. Biopsy showed esthesioneuroblastoma, a rare malignant tumor. She underwent radiotherapy and chemotherapy. She is now free of disease.
Preoperative MRI showing large tumor in brain, nasal cavity and orbit (eye socket)
Operative picture after excision of tumor
Postoperative CT scan showing no tumor
Foramen Magnum Meningioma
A 60-year-old lady presented with weakness of all four limbs. She had difficulty in swallowing. MRI scan showed a large tumor in foramen magnum (junction between cranial cavity and spine). The region is extremely complex and crowded by innumerable vital nerves and blood vessels. She was operated and complete resection of tumor was done. She is now back to her normal life.
Foramen Magnum Meningioma
 
Postoperative MRI scan showing no tumor
 
Skull Base Schwannoma
This 68-year-old lady presented with protrusion of right eyeball and dimness of vision on right side for several months. The vision in right eye was only perception of hand movements. An MRI scan was done. It showed a large tumor in anterior cranial base and right orbit. The tumor encased the optic nerve and ophthalmic artery. It also involved the extraocular muscles and paranasal sinus. We needed a bloodless field for operation to preserve vision. Since the tumor was encasing the ophthalmic artery and optic nerve, for clear dissection we needed a bloodless field. Preoperative embolization was done. She was operated after that. A frontotemporal craniotomy, orbital osteotomy and gross total resection of the tumor was done. The patient’s vision improved well and she could count finger from four feet distance. Postoperative CT scan did not show any tumor. The tumor was a schwannoma, a rare tumor at this site.