Tuesday, April 26, 2011

Doctors Perform Brain Surgery...Through The Nose


(COLUMBUS, Ohio) – Imagine your doctor telling you that you have a brain tumor at the base of your skull, and it could be removed without a single visible scar on your face.  It may sound like the plot of a sci-fi thriller, but it’s actually happening at Ohio State’s James Cancer Hospital.

How?   “We go through the nostril, without performing any incision in the patient’s face or in the head” said Dr. Daniel Prevedello, director of the minimally invasive cranial surgery program at Ohio State University Medical Center.  “It means we don’t have to cut through the flesh or remove large pieces of the skull, which avoids deformation of the patient’s face.”

The approach is known as an endoscopic endonasal approach, in which two surgeons work side by side to remove tumors and lesions at the base of the skull.  A neurosurgeon uses two tiny surgical instruments in one nostril, a head an neck surgeon does the same in the other nostril.  After accessing the base of the brain through the sinus cavity, the surgeons use highly sophisticated mappings of the brain, similar to GPS technology, to find and resect problem areas.  

Most of the tumors and lesions come out the same way the surgical instruments went in - through the nose.  “Some tumors we do have to remove them piecemeal through the nostril” said Dr. Bradley Otto, a head and neck surgeon at the Otolaryngology department at the Ohio State University Medical Center.  “We try not to do that as much as possible, but all of the lesion or the tumor we remove, is removed through the nostril without any incisions in the face.”

Normally, a patient’s face would be cut open or even peeled back to access the base of the skull, but not with this technique.  Going through the nose not only cuts down on recovery time from surgery, but it allows other treatments to take place sooner as well. “You have less normal tissue to heal and you can do radiation and other types of oncological treatment earlier” said Prevedello.

It was the perfect option for Tricia Wharton.  Tricia was eight months pregnant when doctors discovered a tumor at the base of her brain.  Treating the tumor was challenging enough, but doctors also had to consider the health of her unborn child.

“It wasn’t safe for the baby at that time to do radiation or chemo” said Wharton.  So, doctors had to come up with another plan.

Doctors gave Wharton steroid injections to help develop her baby’s lungs as much as possible, then, at 33 weeks, they delivered the baby early.
“I had the C-section on a Sunday and then my sinus surgery on a Friday” said Wharton.  “We were both in the hospital at the same time, in the same hall.  We were just a few floors away from each other so after my surgery I was able to visit her.”

Within a matter of days both mom and baby were cleared to go home, and because Tricia’s recovery time was dramatically reduced due to the endonasal technique, she could not only take care of herself, but her newborn baby.

“I was actually surprised at how fast it healed” she said.  “Three weeks after surgery our life was pretty much back to normal.  I could do almost everything I could before.”

While this type of surgery can prove to be remarkably effective, it is still fairly rare.  Prevedello says only a few medical centers around the world offer the two-surgeon, endoscopic endonasal approach.  In fact, several doctors from Europe spent several weeks in Columbus training in this technique with surgeons at Ohio State’s James Cancer Hospital.

“It’s not something you’ll find common place in a lot of hospitals across many cities” he said.  Dr. Otto agrees, and says because of the uniqueness of the procedure, they’re treating patients from all over the globe.

“Our patient population tends to be not just the Columbus area and the vicinity, but  really throughout the United States and we’ve actually had a few international patients come in as well.”

From http://www.msmediacenter.tv/story.php?id=199&enter