JGH doing brain surgeries through the nose

 

MONTREAL — Surgeons at the Jewish General Hospital (JGH) are now performing some brain surgeries without opening the skull, even to get at tumours deep within the head.

The technique involves removing the growths through the nostrils, using an endoscope – a thin, flexible tube with a light at its tip.

Neurosurgeon Salvatore Di Maio and Marc Tewfik, an ear, nose and throat sinus surgeon, have combined their skills to become leaders in this minimally invasive surgery.

The conventional way of excising tumours located underneath the base of the brain is by making a large cranial opening and retracting the brain, which results in a much longer recovery time and may leave disfiguring facial scars.

“Thanks to endoscopic skull base surgery, recovery time in the hospital usually lasts one or two days, followed by a week or two at home,” said Di Maio.

With the traditional method, the patient can expect to spend up to two weeks in hospital, and take another four to six weeks to recuperate at home, he said.

The two surgeons have been working together since mid-201l, and the collaboration has allowed them to improve their expertise.

Tewfik said that the area behind the nose, where the spine meets the skull, used to be one of the most difficult to reach. With recent technological advances, surgeons now have better access to benign and cancerous tumours of the brain, sinuses and the pituitary gland, as well as the ability to more easily repair defects in the skull.

Open-skull surgery is still performed at the JGH, if that is what is judged best for the patient, Tewfik said.

JGH executive director Hartley Stern added: “We are delighted to offer patients a surgical procedure that’s quicker, simpler and requires much less time for recovery. And since the expense of an operating room and full surgical team are avoided, this procedure is the JGH’s reaffirmation of its commitment to working with colleagues throughout Quebec and across Canada to strengthen the public health-care system by reducing costs through the implementation of superior forms of treatment.”

Di Maio and Tewfik will teach the technique to an international group of doctors in a course at McGill University in June..