Editorial: Advancing multidisciplinary approaches in skull-base tumor management
Year: 2026
Type: editorial
Abstract: State-of-the art management of skull base tumours is the result of collaboration among multiple specialties, particularly otolaryngology, neurosurgery, neuroradiology, radiation oncology and medical oncology. The expertise of a single specialist from each of these fields is therefore no longer sufficient to ensure optimal treatment outcomes in the modern management of skull base tumors. This is because the skull base is an anatomical region where each specialist interprets and manages skull base tumors differently (Table ).Table : Stereotypical thought patterns in the management of skull base tumors by specialty Specialty Approach Otolaryngologist Otolaryngologist How to ensure adequate exposure of the tumor for resection and reconstruct the skull base• Rhinologist How to preserve facial appearance, sense of smell, breathing, vision, and drainage of the paranasal sinuses using endoscopic approaches?• Otologist How to preserve facial appearance and function, hearing, balance, and taste using microscopic approaches through the middle ear? Neurosurgeon How to completely remove an intracranial tumor while preserving vital blood vessels and nerves Radiation oncologist and medical oncologist How to improve patient survival with a combination of nonsurgical and surgical treatments?Where exactly is the tumor located in relation to anatomical structures?The importance of a multidisciplinary approach, including phoniatric care, is also well illustrated by the study by Wang et al. (2025), which, due to the high risk of swallowing disorders, recommends screening for swallowing dysfunction and early postoperative swallowing assessment in patients scheduled for treatment of posterior skull base tumors.Pathologists play a very important role in the management of tumors, as the sinonasal region is the most histologically diverse anatomical area in the human body. In the past, the diagnosis of sinonasal undifferentiated carcinoma (SNUC) was common; today, however, due to more precise molecular-genetic diagnostics, this diagnosis is made less frequently, with the identification of new types of cancer, such as SWI/SNF complex-deficient sinonasal carcinoma. Diagnosis can be challenging, particularly when only more than 100 cases have been described in the literature, as is the case with the adult atypical teratoid rhabdoid tumour described in the article by Hernandez-Rovira et al. ( 2025).The result of multidisciplinary collaboration in the field of skull base surgery is strongly reflected in the transition of surgical approaches from predominantly classical (i.e., microscopic open) approaches to the skull base to endoscopic approaches, which have been adopted over the past three decades from transnasal endoscopic skull base surgery For skull base tumors, there are often no internationally standardized decision-making algorithms for management, and clinical guidelines are frequently inapplicable. In some cases, these guidelines may even conflict with established treatment approaches for skull base tumors; for example, the National Comprehensive Cancer Network (NCCN) guidelines for the management of locally advanced (cT4b) sinonasal cancer [1].(According to the NCCN guidelines, locally advanced sinonasal cancer would always be considered a disease treated non-surgically [1]. One of the cornerstones in the management of skull base tumors is a multidisciplinary team, which serves as the authoritative body within a healthcare institution for the care of such patients [2]. In most institutions, the treatment of skull base tumors represents a smaller but significant part of the overall clinical practice of each member of the multidisciplinary team. For example, an otolaryngologist, who primarily treats sinonasal tumors and inflammatory conditions, manages skull base tumors several times a week. The same applies to other specialists on the multidisciplinary team. Managing a broad spectrum of diseases within one's specialty also fosters flexible thinking in the management of skull base diseases. In our opinion, any patient with a skull base tumor who is not treated in a multidisciplinary manner is deprived of the best possible care. Multidisciplinarity must be strengthened through educational programs in the field of skull base tumors and collegial relationships among specialists from different disciplines.
Source: Frontiers in Oncology
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,801
OpenAlex ID: W7154239645