Brain Surgery Through the Nose

Risks and Rewards

As with any procedure, endoscopic brain surgery carries its share of risks.

One risk, noted Schwartz, was that of infection, given that the surgical tools need to pass through relatively dirty nasal passages into a sterile brain area.

"You need to be very meticulous [about] how you close the skull base after surgery to make sure the opening you made is well-closed," he said.

Also for that reason, said Schwartz, antibiotics are given to the patient.

But, he said, that type of complication is uncommon.

"They don't get infections at a high rate," said Schwartz.

In her own case, Graham said she was told she needed a lumbar drain placed at the base of her spine because of the potential risk of spinal fluid draining into her skull.

"You just do something in a precautionary manner so if there is a leak, you've already taken care of it," said Graham.

Black noted that one of the advantages of the surgery could prove to be a disadvantage, since the incision is further back in the nasal passages.

"If there's a major injury, if you get major bleeding, it's harder to control with the endoscope than the microscope," said Black.

He noted, however, that doing surgeries through the nose has provided benefits overall, even if he considers the endoscope to be only an incremental advance.

Few procedures, Black said, now require cutting into the skull.

"That approach now is reserved for very large tumors that we cannot remove through the nose," he said.

At this point, he estimated, 97 percent of pituitary tumors are done through the nose, not by removing the skull.

Dr. Vijay Anand, an otolaryngologist who performs the operation with Schwartz at New York-Presbyterian Hospital, was more enthusiastic.

"It's a minimally invasive procedure with maximum benefits," he said.

Brain Surgery on the Ground

While endoscopic brain surgery may provide some advantage for people, the biggest beneficiaries of endoscopic brain surgery may walk on four legs.

Lisa Klopp, a veterinary neurosurgeon at the Sams Clinic in San Francisco, learned from a neurosurgeon, who worked on humans, in order to perform endoscopic brain surgery on cats and dogs.

"One of the difficulties with doing brain surgery in dogs and cats is the size of the cranial vault," she said.

The endoscope, she said, has allowed her to fully remove tumors that she could not have fully accessed previously because she could not fully maneuver in the skull of the animal.

"[The endoscope] allows a very good light into an area I wouldn't be able to see into," said Klopp. "Definitely, the majority of tumors I have to do, I wouldn't' be able to see into the areas with a microscope."

The Human Angle

Graham said that the greatest benefit she received in preparing for the surgery was one not available to pets.

"The more information they can have about the procedure, it just really puts them at ease," she said of patients preparing for the operation.

In her own case, Graham said, the tumor had been pressing on her optic nerve, impairing her vision, and after the surgery, the main side effect she noticed was congestion.

Overall, she said, another of the prime benefits she received was excellent care from attentive nurses, something she said is not emphasized enough when people discuss health care.

"My situation was very positive," said Graham. "I'm glad it's over and I'm glad it turned out really well."

-- This embed didnt make it to copy for story id = 8541973. -- This embed didnt make it to copy for story id = 8541973. -- This embed didnt make it to copy for story id = 8541973. -- This embed didnt make it to copy for story id = 8541973. -- This embed didnt make it to copy for story id = 8541973. -- This embed didnt make it to copy for story id = 8541973. -- This embed didnt make it to copy for story id = 8541973. -- This embed didnt make it to copy for story id = 8541973. -- This embed didnt make it to copy for story id = 8541973. -- This embed didnt make it to copy for story id = 8541973. -- This embed didnt make it to copy for story id = 8541973.
Page
  • 1
  • |
  • 2
Join the Discussion
blog comments powered by Disqus
 
You Might Also Like...