Sunday, October 2, 2011

No scars after new surgery removes brain tumours through the nose

By MARTYN HALLE

Last updated at 2:08 AM on 2nd October 2011

Retired company director Ron Jones has undergone a remarkable new form of surgery that allows brain tumours to be removed through the nose.


Traditionally, such operations involved surgeons opening  the skull – a procedure known  as a craniotomy – and delving downwards. 


Alternatively, parts of the brain were reached via large incisions in the side of the face or inside the mouth, all options that leave major scars. 


Revolutionary: Traditionally, such operations involved surgeons opening the skull

Revolutionary: Traditionally, such operations involved surgeons opening the skull

 

But pioneering brain surgeons at Sheffield’s Hallamshire Hospital have adopted a  US-developed technique to reach deep-set tumours using  an endoscope that is fed  through the nose. 


Ron, 83, a former grain salesman who lives in Market Rasen, Lincolnshire, with his wife Sylvia, a former teacher, was diagnosed with a tumour  on his pituitary gland, which  sits at the base of the skull, in October last year. 

 

 

These growths  are ideally suited for nasal endoscopy because the gland is close to the back of the nasal cavity and relatively easy to reach. Ron’s tumour was the size of a small egg. 


Surgeons now hope the success of this operation will pave the way for other types of brain tumour to be removed without making a single incision. 


The tumour is reached by  working through one nostril and making a hole in the back of the nasal cavity into the bottom of the skull. Through this hole, the surgeon can see the bottom of the pituitary gland and the tumour. 


Pioneering: The tumour is reached by working through one nostril and making a hole in the back of the nasal cavity into the bottom of the skull

Pioneering: The tumour is reached by working through one nostril and making a hole in the back of the nasal cavity into the bottom of the skull

 

Cutting instruments, also mounted on flexible or telescopic arms, are used to remove the growth in pieces. 
The new procedure reduces the operating time by up to  two hours, reduces the risk  of infection, and allows for  a quicker recovery compared  to the older techniques. 


Neurosurgeon Saurabh Sinha, who operated on Ron, says: ‘The endoscope provides a close-up view of the pituitary which means we can get all of the tumour out in one go. 


‘Because of Ron’s age, he might not have been considered for open brain surgery, as older patients don’t always recover from such a major procedure. And patients who have weaker hearts will benefit from this innovation. The beauty of the procedure is that there is less danger of brain damage or stroke, and the patient makes  a quicker recovery. 


Before, they may have been in hospital for a week. Now I can discharge some patients within three days.’

‘I first noticed something last year,’ says Ron. ‘I saw a tide mark in my vision. Later, I started having blinding headaches and seeing double.’


Scans showed Ron had a growth on his pituitary gland. About 2,000 people a year require surgery to remove tumours on the pituitary. 


Oval in shape, the gland measures an inch in length and it secretes eight hormones that control vital functions, such as body growth, general health and energy levels. In men it is responsible  for producing the sex hormone testosterone. Ten to 20 per cent of people have a benign pituitary tumour, but only a small  proportion of these cause symptoms, with a tiny fraction needing surgery. Most people are likely to live a normal life without knowing they have a tumour. But Ron’s growth was so large it was pressing on the nerves around the eyes, affecting his vision. 


‘I was also suffering pain in my joints, and having trouble going to the loo which doctors explained wasn’t just my age, but because the tumour was stopping my body from releasing the right hormones,’ says Ron. When he came round from the surgery there wasn’t  a single external mark.


‘When I was told I had a tumour in my head I had visions of my skull being sliced open to remove it,’ he says. ‘Now my sight is back to normal and I have been in no pain at all. I was walking around straight away, and back to playing golf in  two months. My memory isn’t what it was, and I have to write things down or I forget them, but I suppose that could just be my age. Physically, though, I feel better than ever.’

www.neurocare.org.uk

Read more: http://www.dailymail.co.uk/health/article-2043805/No-scars-new-surgery-removes-brain-tumours-nose.html#ixzz1Zdbzr07x