Begin with specialist assessment. Examination and appropriate imaging help define whether the problem arises from the sinonasal tract, skull base or an adjacent structure.
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Advanced ENT · Skull Base · Hisar
Endoscopic Skull Base Evaluation & Surgery
For selected lesions at the interface of the nose, sinuses and skull base, the first question is not simply “Can this be operated endoscopically?” It is “What is the diagnosis, where exactly is it, and which treatment approach is appropriate?”
Where are you in the pathway?
Start with the information you already have.
Existing imaging, pathology and prior treatment records can be reviewed together before deciding whether further investigation, observation, surgery or another treatment pathway is appropriate.
Request report review →Previously treated, recurrent or anatomically complex disease may require detailed reassessment of extent, critical structures, previous surgery and available approaches.
Request advanced opinion →Clinical pathway
Imaging-led diagnosis. Team-based planning. Individualized treatment.
Clinical assessment with CT, MRI or other investigations as indicated.
Endoscopic assessment, pathology or additional testing where required.
Coordinate neurosurgery, radiology, pathology, oncology, endocrinology, ophthalmology or other disciplines according to the lesion.
Observation, biopsy, medical/oncology treatment, endoscopic surgery, open surgery or referral may each be appropriate in different cases.
Post-treatment review, pathology-directed care, imaging surveillance and shared follow-up are planned individually.
Important: endoscopic endonasal surgery uses the nose and sinuses as a surgical corridor for selected skull-base lesions, but suitability depends on the diagnosis, location, extent and relationship to critical neurovascular structures. Some patients are better served by another approach or by non-surgical treatment.
Conditions entering this pathway
A broad category, not one operation.
Sinonasal lesions approaching the skull base
Selected benign or malignant lesions may require assessment of intracranial, orbital or skull-base extension.
CSF leak / skull-base defect
Suspected cerebrospinal-fluid leakage or defects require localization and individualized repair planning.
Pituitary / central skull-base region
Selected lesions may enter a collaborative ENT-neurosurgical pathway after appropriate endocrine, visual and imaging assessment.
Revision or recurrent disease
Prior surgery changes anatomy and may alter the safest route, reconstruction plan and treatment goals.
Skull-base tumour second opinion
Existing scans and reports can be reviewed to clarify options and whether an endoscopic route is suitable.
Need for multidisciplinary referral
Some cases are best managed through coordinated referral rather than treatment within a single specialty.
Advanced Surgical Leadership
Dr Bhushan Kathuria
Network Clinical Director & Lead Surgeon
Advanced ENT and endoscopic skull-base assessment at the Hisar hub is integrated with the appropriate collaborating specialties according to the individual diagnosis. Complex skull-base surgery is presented as team-based care, not as a stand-alone ENT procedure.
View Clinical ProfileBefore a specialist opinion
What to bring.
If available, bring prior CT/MRI images as well as reports, pathology/biopsy reports, operative notes from previous surgery, discharge summaries and a current medication list. The actual imaging is often more useful for surgical planning than the written report alone.
A treatment decision is made only after reviewing the diagnosis, anatomy, alternatives, expected goals and procedure-specific risks.