The thought of having brain surgery can be frightening. Many people think of scars and a shaved head that such a procedure leaves behind.
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But for people with certain types of brain tumors, there’s now a unique surgical option that doesn’t leave a mark.
Instead of creating holes in the skull with a drill to access the brain, the new procedure uses two holes that already lead inside your head: your nostrils.
Two surgeons working side-by-side use tiny, elongated instruments deep inside the nose and a small camera, which they insert through a small opening they create at the base of a patient’s skull.
Less pain, less discomfort
Surgeons Raj Sindwani, MD, and Pablo Recinos, MD, recently performed the surgery at Cleveland Clinic.
“By going through the nose, we can take the brain tumor out without making any cuts or bruises on the patient’s face,” Dr. Sindwani says. “What that translates to is less pain, less discomfort and a much quicker recovery.”
“These surgeries are like a finely orchestrated dance,” Dr. Recinos says. “They require two surgeons to be operating with four hands through the patient’s nose.”
Their patient was Robert Matthews, 47, who had a common tumor called a meningioma in the tissue that covers the brain. His tumor was not cancerous, but it was pressing on key areas of his brain.
The tumor had taken him away from his passion – the performing arts.
“I love doing operas, plays – the hair and make-up for that. I love being a part of the fashion programs. Once this happened and I was diagnosed with a meningioma, everything changed. I couldn’t do it anymore,” Mr. Matthews says.
Over time, the tumor grew, and the physical side effects intensified.
“It had gotten so bad where my speech was impaired. I was starting to have worse headaches and I couldn’t really walk as well as I had before,” Mr. Matthews says.
His physicians presented two options: traditional brain surgery in which his skull would be cut open or the new procedure in which the tumor could be removed through his nose.
Mr. Matthews was sold on the new procedure when he learned there would little physical evidence that he had any brain surgery.
“There are no cuts. You don’t have to have your head shaved. You don’t have to have all of the scars,” Mr. Matthews says. “It sounded like I could get right back into the swing of things, so I thought, well maybe that’s the way to go.”
Twelve hours later, his tumor was gone.
“I’ve had my surgery, 12 hours’ worth of people working on me and then to come out and not even look like I’ve had surgery, is wonderful,” Mr. Matthews says.
Any patient who has a tumor at the base of the skull could be considered for this type of procedure, but not all of these patients will be a good candidate. Also, there is a greater risk – like a lost sense of smell – to the patient’s nose when surgery is performed through the nostrils. However, this also is a risk with traditional open-brain surgery.