BRAIN TUMOR SURGERY -CONVENTIONAL APROACH

Patients who suffer from brain tumor usually need surgery as part of overall management. Conventional approach to brain tumors has been through a craniotomy (making a window on the skull).This form allows the neurosurgeon to adequately visualize the tumor and manipulate the surrounding structures ensuring safe removal. With the advent of minimal access surgery in other parts of the body, there is an increasing tendency to minimize the size of the skull opening or incision.

NEWER APPROACH :

In general, endoscopic surgery forms the basis of minimal access surgery for all other parts of the body. Recently, due to technological improvements and a drive towards less invasive surgical procedures, the use of endoscopy has expanded in neurosurgery. The introduction of the endoscope in neurosurgery is the result of technological advancements in the camera's design, including reduced size, improved resolution and brighter illumination.

Endoscpoic neurosurgery involves the insertion of an endoscope, or tiny video camera, through a small incision to treat a range of neurological conditions. The result is

• Faster and simpler procedure
• Reduced post -operative complications
• Faster recovery
• Less pain and scarring

MINIMALLY INVASIVE EXPANDED ENDOSCOPIC TRANS -NASAL APPROACH

The endoscopic trans -nasal approach is performed through the nostrils. A natural passage way exists at the back end of the nose leading into the sphenoid sinus (an air filled cavity in the depth of the skull), which can be enlarged so that the endoscope and instruments can pass into this air filled cavity. From this region the sella turcica is easily accessed, which is the location of pituitary gland. Neurosurgeons use this route normally to remove the tumor from pituitary (the master glad).

BREAK THROUGH IN BRAIN TUMOR SURGERY- FIRST TIME IN INDIA (REMOVAL OF BRAIN TUMOR THROUH NOSE)

The surgery was performed on a 40 year old lady who was detected with a tumor measuring 2 cm which was pressuring her right optic nerve and therefore, threatening her vision. The patient was examined by Dr Rajakumar , Neurosurgeon and his team, and several tests including the MRI were performed. After discussing various options with the family, Dr. Rajakumar decided to remove the tumor through nose.

This was a pioneering technique of removing a meningioma (a type of benign brain tumor) using a endoscope through he nose. The successful removals of this kind of tumor through the nose require exceptional skills. This technique has created ripples in the health care community. Generally it is hazardous to perform this surgery without perquisite skill and specialized equipment.