Skull base and endoscopic procedures in cancer patients

Neurosurgery is a technically complex procedure requiring interdisciplinary teamwork. Neurosurgery around the brainstem offers a higher degree of complexity and substantial risk to postoperative outcomes. Patients with brainstem neoplasms often present with subtle and complex neurological signs and symptoms. Neoplastic tissues of the brain and/or brainstem typically require either typical or atypical neurosurgical approaches to tumor resections. Radiological evaluation often provides substantial information relative to neoplastic consistency, anatomical location, and structural involvement and opportunities to determine the best surgical approach. Depending on the type of neoplasm, comorbidities, location of neoplasm, technical difficulty of the surgical procedure, and perioperative stability determine patient outcomes. Modern neurosurgical approaches have transformed surgical interventions with the use of high-powered intraoperative microscopes, image-guided neuro-navigation systems, nasal endoscopic instruments, and ultrasonic aspirators (Nyquist et al., World Neurosurg 82:S54-S58, 2014). The section will provide a brief overview of the approach to patients with skull base lesions and management throughout the surgical journey.