newsletter

Spring 2017
Our neurosurgeons use transnasal approaches to treat tumors in the suprasellar region to avoid open craniotomies when possible.
Changing The Way Skull Base Disorders Are Treated With Minimally Invasive Surgery

Carolina NeuroSurgery & Spine Associates is dedicated to continually implementing minimally invasive neurosurgical techniques for both brain and spine surgery. These procedures result in less trauma and decreased recovery time for patients, and usually require much smaller incisions.

Our neurosurgeons are now approaching skull base brain surgery with minimally invasive techniques. The skull base is the lower part of the skull on which the brain sits. It separates the brain from the eyes, sinuses and ears. Historically, disorders in the skull base, including certain tumors, aneurysms, cerebrospinal fluid leaks and cavernous malformations, either were inoperable or required open surgery in which part of the skull was removed to access the brain. However, we are now using innovative minimally invasive procedures to access the skull base through the nasal passages and incisions above the eyebrow.

Transnasal Approach To Skull Base Surgery
We have found that accessing the skull base with transnasal approaches through the nostrils and sinuses is become increasingly useful for complex lesions that previously required more invasive cranial surgery. In the past, only pituitary tumors positioned behind the nose and below the skull were treated with a transnasal approach. Significant improvements in endoscopic equipment, navigational tools and our ability to utilize nasal septal flaps to repair skull base defects have led to the advancement of newer transnasal intracranial techniques. Now, working in conjunction with ear, nose and throat surgeons, we utilize these less invasive approaches to treat tumors, including meningiomas or craniopharyngiomas in the suprasellar region, previously not thought treatable through this route. As with any neurosurgical procedure, there are still risks involved, but advantages include less postoperative pain and potentially shorter hospital stays.

Eyebrow Approach To Skull Base Surgery
The supraorbital eyebrow is another newer minimally invasive approach our neurosurgeons now use to access brain tumors (meningiomas, craniopharyngiomas, etc.) and cerebrovascular anomalies (ruptured and unruptured aneurysms, arteriovenous malformations, cavernous malformations, etc.). This procedure involves making a small incision within the eyebrow. This allows for excellent cosmetic results. The skin and muscle are retracted and a "keyhole" craniotomy of about 2 cm is created so that the brain can be accessed with a surgical microscope and endoscope through the eyebrow incision.

Both the transnasal and eyebrow approaches to skull base brain surgery offer much better cosmetic results compared to traditional open procedures, which require large incisions in the scalp and a portion of hair to be shaved. More important, these minimally invasive techniques cause less disruption and damage to blood vessels, nerves and other tissue. These transnasal and eyebrow approaches to skull base surgery require significant neurosurgical expertise and highly advanced instrumentation. Carolina Neurosurgery & Spine Associates is pleased to offer patients both the experience and expertise needed for these minimally invasive approaches in appropriate cases.

For additional information, call 800-344-6716.

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