Dr. Vidhyadharan Sivakumar is a fellowship-trained head and neck surgeon with specialized expertise in skull base surgery. He treats complex tumors and conditions affecting the interface between the head/neck and brain, including sinonasal tumors, nasopharyngeal tumors, temporal bone lesions, and anterior skull base pathology. His advanced training includes both endoscopic and open approaches for optimal outcomes.
With extensive experience in managing challenging skull base pathology, Dr. Vidhyadharan works in close collaboration with neurosurgeons, neuro-radiologists, and radiation oncologists. His multidisciplinary approach ensures comprehensive care for complex cases requiring coordinated surgical strategies.
Dr. Vidhyadharan Sivakumar ENT & Head Neck Surgical Oncologist
Dr. Vidhyadharan's Expertise
15+ years experience | Extensive skull base surgery experience | Endoscopic skull base expert | Complex tumor management | Multidisciplinary team approach | Advanced reconstruction techniques | Nerve preservation expertise
Warning Signs - When to Seek Skull Base Evaluation
Consult Dr. Vidhyadharan if you experience any of these symptoms:
Persistent nasal obstruction (one-sided)
Recurrent nosebleeds
Clear nasal discharge (possible CSF leak)
Vision changes or double vision
Facial pain or numbness
Bulging eye or vision loss
Hearing loss or pulsatile tinnitus
Persistent headaches
Facial swelling or mass
Loss of smell
Difficulty swallowing or nasal regurgitation
Neck mass with cranial nerve symptoms
Early diagnosis and treatment significantly improve outcomes
Dr. Vidhyadharan's Skull Base Surgery Approaches
Endoscopic Skull Base Surgery
Minimally invasive approach through the nose for anterior skull base tumors, pituitary lesions, and CSF leak repair. Benefits include no external scars, faster recovery, better visualization, and preserved brain retraction. Performed with neurosurgery team.
Open Skull Base Approaches
For extensive tumors, traditional open approaches (anterior craniofacial resection, infratemporal fossa approach, lateral skull base approaches) provide comprehensive tumor removal with acceptable morbidity and good functional outcomes.
Nerve-Sparing Techniques
Specialized techniques to preserve cranial nerves controlling eye movement, facial sensation, facial movement, and swallowing. Intraoperative nerve monitoring ensures maximal preservation of function.
Skull Base Reconstruction
Complex reconstruction after tumor removal using local flaps, regional flaps, or free tissue transfer. Essential to prevent CSF leak, maintain brain protection, and restore cosmesis. Expertise in multi-layer reconstruction.
Why Choose Dr. Vidhyadharan for Skull Base Surgery
Fellowship-trained with specialized skull base surgery expertise
Proficient in both endoscopic and open skull base approaches
Multidisciplinary team with neurosurgeons for combined cases
Advanced imaging and navigation technology available
Experience with complex and revision skull base tumors
Focus on nerve preservation and functional outcomes
Comprehensive reconstruction capabilities
Access to advanced facilities at THANC Hospital
Advanced Technology & Techniques
Endoscopic Skull Base InstrumentationImage-Guided Navigation SystemsIntraoperative Nerve Monitoring4K High-Definition EndoscopyAdvanced CT & MRI ImagingDoppler Ultrasound for Vascular Mapping
15+
Years of Experience
Head & Neck
Fellowship Training
Endoscopic & Open
Approach Options
Yes
Multidisciplinary Care
Your Skull Base Surgery Journey with Dr. Vidhyadharan
Understanding what to expect can help reduce anxiety and prepare you for treatment
1
Comprehensive Skull Base Evaluation
Detailed history and examination including cranial nerve assessment. High-resolution CT and MRI with contrast. Endoscopic examination. Biopsy if needed. Review of outside imaging and pathology.
2
Multidisciplinary Tumor Board
Your case discussed with neurosurgeons, neuro-radiologists, medical oncologists, and radiation oncologists. Team determines optimal surgical approach, need for combined surgery, and adjuvant treatment planning.
3
Pre-operative Planning
Detailed surgical planning with 3D imaging reconstruction. Anesthesia assessment. Discussion of expected outcomes, potential complications, cranial nerve risks. Consent for complex surgery. Emotional support and counseling.
4
Skull Base Surgery
Surgery performed under general anesthesia, typically 4-8 hours depending on complexity. ICU monitoring post-operatively. Hospital stay 5-10 days. Close monitoring for complications including CSF leak, bleeding, or infection.
5
Recovery & Follow-up
Post-operative imaging to confirm complete resection. Pathology review determines need for radiation. Regular endoscopic surveillance. Cranial nerve rehabilitation if needed. Long-term monitoring for recurrence with imaging.
Frequently Asked Questions
What is the skull base and why is surgery there complex?
The skull base is the bottom of the skull separating the brain from facial structures. It contains critical structures including major blood vessels, cranial nerves controlling vision, smell, facial movement, and swallowing, and brain tissue. Surgery requires specialized training to safely remove tumors while preserving these vital structures.
What is endoscopic skull base surgery?
Endoscopic skull base surgery accesses tumors through the nose using cameras and specialized instruments. Benefits include no facial scars, better visualization with magnification, less brain retraction, faster recovery, and shorter hospital stay. Best for anterior skull base lesions and pituitary tumors. Dr. Vidhyadharan performs these with neurosurgery team.
What are risks of skull base surgery?
Risks include CSF leak (5-10%), meningitis, cranial nerve injury affecting vision, smell, facial sensation or movement, stroke, bleeding, and need for revision surgery. Serious complications are minimized with experienced teams. Benefits of tumor removal usually outweigh risks. Dr. Vidhyadharan's multidisciplinary approach reduces complications.
How long is recovery after skull base surgery?
Recovery depends on approach. Endoscopic surgery allows discharge in 3-5 days with return to activity in 2-3 weeks. Open approaches require 7-10 days hospitalization and 6-8 weeks for complete recovery. Complete healing takes 3-6 months. Regular follow-up ensures optimal recovery monitoring.
Will I need radiation after skull base surgery?
Need for radiation depends on tumor type and completeness of resection. Benign tumors with complete removal may not need radiation. Malignant tumors or positive margins typically require adjuvant radiation with or without chemotherapy. Decision made by multidisciplinary team based on final pathology.
What is chance of tumor recurrence?
Recurrence rates vary by tumor type. Benign tumors like inverted papilloma have 5-10% recurrence with complete removal. Malignant tumors have higher rates (20-40%) depending on stage and grade. Regular surveillance with endoscopy and imaging allows early detection and treatment of recurrence. Long-term follow-up is essential.
Can all skull base tumors be removed completely?
Most skull base tumors can be completely removed, but some highly invasive cancers or tumors involving critical vessels may only allow partial removal. In these cases, surgery is combined with radiation for control. Dr. Vidhyadharan will discuss realistic expectations based on individual tumor characteristics.
Do you work with neurosurgeons for complex cases?
Yes, many skull base surgeries are performed jointly with neurosurgeons for optimal outcomes. Dr. Vidhyadharan works closely with experienced neurosurgeons at THANC Hospital. Combined approach allows comprehensive tumor removal with brain protection and reconstruction by the most qualified specialists.
What is a sinonasal tumor and how is it treated?
Sinonasal tumors arise from the nasal cavity or paranasal sinuses and can be benign (inverted papilloma) or malignant (squamous cell carcinoma, adenocarcinoma, esthesioneuroblastoma). Treatment typically involves endoscopic or open surgical removal, often followed by radiation therapy for malignant tumors. Dr. Vidhyadharan has extensive experience with complex sinonasal tumor surgery using both endoscopic and open approaches.
What is a CSF leak and how is it repaired?
CSF (cerebrospinal fluid) leak occurs when there is a defect in the skull base allowing brain fluid to leak into the nose, presenting as clear nasal discharge. It can occur spontaneously or after trauma or surgery. Repair is essential to prevent meningitis. Most CSF leaks can be repaired endoscopically through the nose using multilayer reconstruction techniques with high success rates (>95%).
How much does skull base surgery cost in Chennai?
Skull base surgery costs depend on tumor type and location, surgical approach (endoscopic vs. open), need for combined surgery with neurosurgery, use of navigation systems, ICU requirements, hospital stay duration, and individual patient complexity. THANC Hospital and Dr. Vidhyadharan provide comprehensive skull base surgery with advanced endoscopic equipment and multidisciplinary expertise at economical costs. Detailed cost estimates are provided during consultation based on your specific condition.
What is juvenile nasopharyngeal angiofibroma and how is it treated?
Juvenile nasopharyngeal angiofibroma is a benign but locally aggressive vascular tumor occurring in adolescent males. It causes nosebleeds and nasal obstruction. Treatment is surgical removal, which can be challenging due to heavy bleeding. Pre-operative embolization reduces blood loss. Dr. Vidhyadharan has experience managing these complex tumors with excellent outcomes using endoscopic or combined approaches.
