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For patients travelling from Zimbabwe

Skull-Base Surgery for patients in Zimbabwe

You may have been told there is a growth behind your nose, near the pituitary gland or next to the hearing nerve. This page explains what that means, how it can be treated and what recovery looks like. If you live in Zimbabwe, your own doctor can refer you, and the rooms help you plan travel to Johannesburg for an in-person consultation. Some Zimbabwean funders may authorise treatment in Johannesburg. On request, the practice provides the clinical motivation and coding that funders ask for.

Illustrative image: Rigid endoscope with a glowing tip on a navy drape in a modern operating theatreIllustrative image

Medical aid & funders

Some Zimbabwean funders may authorise treatment in Johannesburg. On request, the practice provides the clinical motivation and coding that funders ask for.

  • Cimas Health Group

    Cimas may consider referral to Johannesburg, subject to its own pre-authorisation process and your benefit option. Confirm cover with Cimas directly.

  • Other Zimbabwean medical aid societies

    Confirm cross-border cover and required documentation with your fund before travel.

Travel & arrival

Departing from
Robert Gabriel Mugabe International Airport, Harare
Arriving at
O.R. Tambo International Airport or Lanseria International Airport
Hospital
Netcare Milpark Hospital, Parktown West (approx. 45 minutes by road from O.R. Tambo; 35 minutes from Lanseria)

Scheduled flights connect Harare and Bulawayo with Johannesburg. Road travel is via the Beitbridge border post.

Urgent transfers and air ambulance coordination

Your records & POPIA

Sending medical records from Zimbabwe to a practice in South Africa is a cross-border transfer of personal information, which may also be regulated by the data protection law of Zimbabwe. The secure referral portal explains which information is transferred, and where it is processed, and asks for explicit consent before anything is submitted.

  1. 01 Your doctor uploads the referral and imaging
  2. 02 Travel planning call (logistics only)
  3. 03 Funder documents supplied on request
  4. 04 Consultation about skull-base surgery in person in Johannesburg
Start a secure referral

Dr Nadir Kana practises independently at Netcare Milpark Hospital in Johannesburg, where skull-base procedures are planned and performed jointly with neurosurgical colleagues.

What is the skull base?

The skull base is the bony floor that separates the brain from the structures of the face, nose, ears and upper neck. Critical nerves and blood vessels pass through small openings in this region, including the optic nerves, the facial nerve and the internal carotid arteries.

Because the anatomy is complex, conditions in this area are usually managed by a team that combines otorhinolaryngology (ENT) and neurosurgery, with input from radiology, endocrinology, oncology and anaesthesia.

Endoscopic endonasal approach

Many lesions of the anterior skull base and pituitary region can be reached through the nasal passages using rigid endoscopes and specialised instruments. This approach avoids external facial incisions and, where clinically appropriate, reduces the need to retract brain tissue.

At the end of the procedure the opening in the skull base is carefully rebuilt, commonly using a flap of tissue from inside the nose. This step is essential for preventing a leak of cerebrospinal fluid after surgery.

Lateral skull base and temporal bone

Tumours such as vestibular schwannomas arise near the inner ear and facial nerve. Management options include observation with serial MRI, stereotactic radiotherapy, or microsurgical resection. The choice depends on tumour size, growth, hearing status, age and the patient's own priorities.

Where surgery is recommended, intraoperative facial nerve monitoring is used to support nerve preservation. The specific risks, including hearing loss and facial weakness, are discussed in detail during consultation.

Postoperative care

Patients having major skull-base procedures are admitted to Netcare Milpark Hospital, and high care or intensive care is arranged where the procedure requires it. The expected length of stay, follow-up imaging schedule and activity restrictions are provided in writing before surgery.

Treatments in this area

  • Endoscopic endonasal skull-base surgery
  • Vestibular schwannoma (acoustic neuroma) resection
  • Transsphenoidal pituitary adenoma surgery
  • Cerebrospinal fluid (CSF) leak repair
  • Anterior skull-base reconstruction

Your care team may include: ENT and head & neck surgery, Neurosurgery, Neuroradiology, Endocrinology and ophthalmology where indicated, Adult intensive care.

For referring doctors

When to refer, and what to send

Send a secure referral

The referral form asks for consent to records being sent from Zimbabwe to South Africa and processed on servers outside South Africa (POPIA Section 72). The data protection law of Zimbabwe may also apply.

Referral criteria

  • Radiologically confirmed lesion of the anterior, middle or lateral skull base
  • Suspected or confirmed CSF rhinorrhoea (beta-2 transferrin positive or clinical suspicion after trauma)
  • Pituitary lesion requiring surgical opinion, ideally with endocrine work-up
  • Progressive asymmetric sensorineural hearing loss with an internal auditory canal lesion on MRI

Helpful work-up before consultation

  • MRI with gadolinium (DICOM files preferred over printed films)
  • Fine-cut CT of the paranasal sinuses or temporal bone where relevant
  • Pure-tone audiogram for lateral skull-base lesions
  • Pituitary hormone profile and visual field assessment for sellar lesions

Common questions

Things people often ask

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Will I have a scar on my face after endoscopic skull-base surgery?

Endoscopic endonasal procedures are performed through the nostrils and do not usually require an external facial incision. Some cases require a combined or open approach; this is determined from your imaging and discussed with you beforehand.

Can my scans be reviewed before I travel to Johannesburg?

Yes. Referring practitioners can upload MRI and CT studies in DICOM format through the secure referral portal. The referral is reviewed with your doctor before an in-person consultation in Johannesburg is arranged. No diagnosis or clinical advice is given to patients outside South Africa before they are seen in person.

Which hospital is skull-base surgery performed at?

Dr Kana performs skull-base procedures at Netcare Milpark Hospital in Parktown West, Johannesburg, together with neurosurgical colleagues.

Medically reviewed by Dr Nadir Kana, Otorhinolaryngology (ENT) and Head & Neck Surgery. Last reviewed .