Skull Base Surgery FAQs
If you’ve just been diagnosed with a brain lesion, likely you are feeling so many things. We know it can be overwhelming for patients and their families to be propelled suddenly into medicine’s most advanced world–– hearing a whole new language, learning about technology and meeting a team of specialists. We are here to help you and your family make sense of it all. Our multidisciplinary team of specialists is devoted to your personal progress and we will help you take it one step at a time. Every patient is unique and our goal is to get you back to what is most important in your life.
Frequently Asked Questions
The following is a list of questions most frequently asked by our patients. While not comprehensive, we hope this information will help you prepare for your procedure and ease some of your anxiety. If you have any further questions please do not hesitate to contact our office.
What should I bring to my consultation?
Copies of your imaging (films or a CD), medical history, a list of all medications (prescriptions, over the counter meds, dietary supplements, alternative/holistic medicines), a list of allergies, contact information for any doctors we should communicate with, and your insurance card(s). Note: if you take more medications than you can remember you should always have a list of what you are currently taking on your person or in your wallet, along with emergency contact and doctor information.
Do I have to contact my insurance company?
No, we will get authorization from your insurance company. Feel free to discuss any financial questions or concerns with your surgeon.
What should I tell my job?
Your employer may require you to submit disability forms. We can process them after you provide signed permission for the release of your medical information. Your surgeon will estimate your recovery time and when you can expect to return to work. Keep in mind that these estimates may change, based on your individual circumstances.
What surgical approach is the best for me?
This is determined by your surgeon based on the procedure and surgical location. While most patients would like the least invasive surgery possible, your case may require a different approach.
What about pre-testing?
Everyone needs pre-testing. If you have underlying heart or lung problems, you may need written clearance from your cardiologist or pulmonologist. If pre-testing is done at Mount Sinai we can access the results immediately. If you go elsewhere, you should complete pre-testing five to seven days before surgery to allow enough time for our office to receive the results and identify any unexpected health issues. Note: make sure you let the anesthesiologist know if you have any dental problems.
What about my medications?
Stop Coumadin and NSAIDs (ibuprofen, naprosyn, and aspirin) seven days prior to surgery. If you are on Plavix or other anticoagulants, discuss stopping it with the prescribing doctor. Your surgeon may want you to take some of your medications, such as blood pressure medications, the morning of surgery with a small sip of water. Avoid alcohol and cigarettes. Follow your surgeon’s instructions and call with any questions.
What if I get sick?
If you develop a cold, virus, sore throat, or other illness within a week of your scheduled surgery, contact your surgeon immediately to determine whether your procedure should be postponed.
Do I need to follow a special diet?
There are no dietary restrictions unless you follow a special diet for other reasons. A healthy, well-balanced diet containing adequate amounts of protein, fruits, and vegetables is good advice for everyone.
Should I or my family donate blood to be used for my case prior to surgery?
This is generally unnecessary. If you need a transfusion during your procedure, rest assured that all blood products are carefully tested for a number of diseases, including HIV. If you prefer, you can make arrangements in advance for an “autologous donation.” Ask your surgeon for a prescription and contact the Blood Donor Center (212-241-6104). Note: patients whose religious beliefs don’t allow for blood transfusions should discuss this in advance with their surgeon.
When should I stop eating and drinking?
You should not take anything by mouth after midnight the night before surgery. If your surgeon has instructed you to take any medications in the morning, you may take them with a very small sip of water. If you eat or drink anything else, surgery may be postponed.
What should I bring to the hospital?
Hospital robes and toiletries will be supplied, but you may bring any items that will make you feel at home.
You should also bring:
- Insurance card/information
- Dentures and Eyeglasses (not contact lenses)
- List of medications and dosage information.
- Small amount of cash for newspapers, etc.
- List of allergies
- Medications the hospital cannot provide (it will be re-labeled for in-hospital use)
- Emergency contact number, preferably a cell phone number
- Completed Health Care Proxy form, if you have one
- Contact numbers for physicians, family, and friends
Where do I check in the morning of surgery?
Admitting is located on the 2nd floor of the Guggenheim Pavilion (GP) at 1468 Madison Avenue (at 100th Street). Usually your companion(s) can accompany you to the holding area outside of the operating room, and then return to the waiting area during surgery. Please designate one contact; hospital staff will not give information to multiple people over the telephone because of the privacy stipulations of the federal Health Insurance Portability and Accountability Act (HIPAA). Your designee will receive a pager and the surgeon will call when surgery is complete.
Who will perform the surgery?
The attending neurosurgeon will perform the operation with assistance from supervised residents.
How long will the surgery take?
This depends on the procedure, the location, and the surgical approach. Your surgeon will discuss the specifics of your case with you. After surgery you will recover in the Post Anesthesia Care Unit (PACU) or the Neurosurgical Intensive Care Unit (NSICU).
When can my family see me?
Usually after transfer out of the PACU to a bed on the surgical floor in the Guggenheim Pavilion, 8-West (212-241-5558). If you recover in the NSICU (212-241-2100) the staff will let your family know when they can see you. Visiting hours are generally from 11:00 am until 9:00 pm.
Will I have a lot of pain afterwards? How will that be managed?
Pain varies depending on the type of surgery and the patient. Your pain will be monitored and medication provided if you need it. Report any previous reactions to opioid painkillers, such as codeine, Vicodin, Percocet, morphine, fentanyl, Dilaudid, etc. If you know that one medicine works better for you than another, let us know. If you have had a bad experience with anesthesia, tell your surgeon and anesthesiologist before surgery; medication can prevent nausea and vomiting.
How will I feel afterwards?
You will be very fatigued. You may have nausea or vomiting from the anesthesia which can be treated with medication. It usually resolves in 24 hours. Head pain and incision pain is common. If a transnasal approach was used, you may have nasal packing requiring you to breathe through your mouth. Your surgeon will tell you when you can have ice chips for your dry mouth. You may have a little trouble swallowing for a few days after surgery, either from the procedure or the breathing tube. This generally resolves within a few days. Eat only soft, easy-to-swallow foods during this period. You may be a bit hoarse. This should resolve on its own within a few days to weeks. If not, there is a small injection procedure that can be done to restore vocal function.
Will I need a private duty nurse?
Not usually, but they are available if you pay privately. Call 212-241-7383 for more information.
Can I have a family member stay with me overnight?
If you have a private room, yes. If a cot is available, one will be provided. Family members may not stay overnight in the NSICU.
How can I get a private room?
To guarantee a private room, you will have to make payment arrangements in advance. Call the Admissions Office at 212-241-1900.
Are telephone, TV and WiFi Service available?
A personal telephone and TV are available for $13 total per day. Charges can be applied to your home telephone bill and paid after you leave the hospital. A staff member can arrange these services. Free WiFi service is available in most areas of the hospital.
How long will I be in the hospital?
Usually just one to three days, depending on the type of surgery and your overall health. Patients who need inpatient rehabilitation stay longer.
Will I need a visiting nurse or home health aide at home?
Before you are discharged you will be evaluated by a physical therapist who may recommend visiting nurse or physical therapy services. In that case, the visiting nurse will evaluate your needs for services and equipment. Unfortunately, not all insurance plans cover these services, but the social worker will assist you in making arrangements.
How do I get home?
Plan ahead. Ask a family member or friend to escort and assist you at home, or make arrangements for a car service or ambulette. Please note that most insurance plans do not cover transportation.
Will I have any activity restrictions?
Patients are encouraged to get up and start walking as soon as they are physically able. Prolonged periods of bed rest are discouraged unless medically necessary. Most patients should avoid heavy lifting after neurosurgical procedures. Other activities are usually resumed as tolerated. Your surgeon will give you specific instructions.
When can I drive?
This is discussed at your post-operative visit. If you have visual or mobility problems, or a history of seizures, your surgeon may ask you to avoid driving for a while.
When should I call the doctor?
Call if you have a fever, redness, or discharge from the wound, increased tenderness, or wound separation. You should also call with any new symptoms that concern you, or any questions that arise. Call your surgeon or nurse within a few days of returning home to provide an update on your progress and arrange for your follow-up visit.