Head and Neck tumours and Cancers are a relatively uncommon form of cancer representing about 5% of all cancers. Within the head and neck region cancers of the nose, sinuses, eye socket region and spaces around the skull base (beneath the brain, behind the eyes) are even more uncommon and represent only 5% of all head and neck cancers. Thus these rare tumours are the 5% of the 5%!
In Scotland there are fortunately only about 55 new cases of sinonasal and skull base cancers each year. This low rate of occurrence is fortunate as these tumours are often associated with unpleasant effects due to involvement of vital structures such as the eye and brain.
However, while there is a reasonable level of awareness of some of the other types of Head and Neck cancer, both Doctors and the General Public are quite unaware of sinonasal and skull base tumours. This lack of awareness and the fact that these tumours often start with fairly minor symptoms (blocked nose, swelling of eye, blood stained nasal discharge etc) means that patients often don’t consult their GP and that diagnosis is often missed until the tumour is at an advanced stage.
Treatment of these tumours has traditionally involved major surgical procedures often needing facial scars and sometimes disfigurement along with radiotherapy and other treatments. In recent years a range of new, “keyhole” or endoscopic surgical operations have been developed to allow removal of these tumours without large incisions and sometimes treatment can be carried out entirely through the nose. This type of modern “endoscopic skull base surgery” is highly specialized and uses extremely specialized instruments and technology. This special surgical “Kit” enables suitably experienced surgeons to remove these tumours without damaging nearby structures such as the brain , eyes and major blood vessels. Endoscopic skull base surgeons will often use special satnav machines and electronic devices to carry out these operations in a safe way.
The team at Glasgow Royal Infirmary have for many years been at the forefront of this type of surgery and continue to develop techniques to help our patients.
In order to further this development we need:-
- Increased awareness of these tumours and the warning signs
- Investment in expensive technology to help us operate safely
- Support for research and training in this are for the medical team
Professor G.W.McGarry MD FRCSEd
Consultant Anterior Skull Base Surgeon, ENT and Head and Neck Surgeon
Greater Glasgow and Clyde NHS