Transcript of video:
Over the years, we’ve learned that the ear provides a marvelous way to reach growths or tumors that involve the base of the skull. Often these involve nerves at the base of the skull. Because of the position of the ear, manipulating the ear allows us to work together with the neurosurgeon to more safely reach these areas without having to put pressure on the brain. There are basically four strategies that we can use:
One is that we can go through the inner ear – so if we think about the ear, that would involve actually going through the bone of the inner ear to reach tumors that are in this location. By doing that, we open up a corridor to get to this part of the base of the brain without having to put pressure on the base of the brain. Another strategy is to come from above. When we come from above, we gently hold the lining of the brain out of the way, and then carefully remove the bone. That blocks access to the nerves of hearing and balance and facial function at the base of the skull.
Another strategy is to come from in front of the ear. In these strategies, we’re able to enter spaces of cysts to drain or tumors that involve the blood vessels and nerves at the base of the skull.
Another strategy is to come all the way behind the inner ear, such as the retrosigmoid operation that we use with acoustic tumors. And the advantage of that procedure is that we don’t have to damage the inner ear, and it gives us an opportunity to save hearing.
The final strategy is to come from below. There are certain lesions of the skull base, like cysts or cholesterol granulomas, where we can sneak in between the blood vessels like the carotid artery and the jugular vein to reach the base of the skull and drain these lesions and protect the important nerves and blood vessels in this area.
In essence, then the ear becomes a corridor to reach tumors and growths at the base of the skull.