The cranial base is the lower part of the skull where the brain meets the spine. Just beneath this area is the upper neck, which contains many important nerves, blood vessels, salivary glands and soft tissues. Tumours in this region can be complex because they sit close to structures that control swallowing, speech, shoulder movement, hearing and facial sensation. Tumours in this region include neuromas, paragangliomas, salivary gland and soft tissue sarcomas
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People may notice symptoms such as a lump in the neck, hoarseness, difficulty swallowing, ear pain, shoulder weakness, changes in facial movement or hearing changes, depending on which nerves or tissues are involved.
These complex tumours can be benign (non-cancerous) or malignant (cancerous). Even benign tumours can cause problems because of their position, which is why they have to be treated by a highly specialist skull base team.
These are invasive, can metastasise and require oncologic management.
These are slow-growing, non-invasive, and don’t metastasise, but they can still cause serious symptoms due to their location:
There are also tumours which are described as ‘variable’, this means they can be benign in some people and malignant in others. For example, tumours of deep neck spaces (parapharyngeal space, infratemporal fossa) nerve tumours and salivary gland tumours.
Treatment depends on the tumour type and location, but surgery is often critical. Many tumours can be removed using minimally invasive (endoscopic surgery through the nose) or keyhole techniques (often behind the ear), but some require more traditional surgery (where incisions are made in the neck or skull) because of their depth or closeness to nerves. The aim is always to remove the tumour safely while protecting nerve function.
After tumour removal, the MDT team at Skull Base Specialists will reconstruct the skull base, nerves, soft tissues of the neck and/or the appearance of the face (using advanced facial plastics techniques). For malignant tumours that cannot be fully removed cancer treatments, like radiotherapy, can be used. Some neck and cranial base tumours (like paragangliomas or nerve tumours) are safer to treat with radiation.
Long term follow up requires input from many different healthcare professionals usually. It may encompass long-term follow up with imaging, nerve function checks, speech therapy, swallowing assessments and hearing tests.
Neck and cranial base tumours are rare growths that sit close to vital nerves and blood vessels, click here to learn more about advanced treatment from the Skull Base Specialists.
