No Scars
Due to its highly invasive nature and the potential for significant and prominent scars, many people consider brain surgery to be a cure that is worse than the disease. Today Loyola is one of the few medical centers in Chicago to commonly use an endoscope (a tiny camera and a light source) to access tissue inside the skull base. This minimally invasive approach eliminates the disfigurement associated with cutting directly into the skull and closing the opening with staples. And it’s used for treating a variety of neurological conditions.
The surgeon can position the endoscope to within a tenth of an inch of the target area. “We’re able to get an extremely good view of tumors that previously required much bigger and more invasive surgeries to get the same visualization,” said Chad Zender, MD, assistant professor, otolaryngology, Loyola University Chicago Stritch School of Medicine. “We can more easily see the tumor and remove it effectively in a way that is less debilitating for the patient.”
For pituitary tumors and tumors arising from the covering of the brain, physicians can access the brain by inserting instruments through the patient’s nose and cutting a one-third-inch-wide hole in the skull base. The endoscope enters one nostril and the surgical instrument the other. In some cases, such as repairing aneurysms and the surgical treatment of epilepsy, a similarly small bone opening can be made in the side of the skull base through a small incision behind the hairline, without shaving any hair.
Loyola surgeons routinely use this procedure to remove tumors on the pituitary gland, which sits at the base of the skull just beyond the nasal passage. “I use the endoscope so that I can see that I have removed as much of the tumor as I can safely,” said Edward Duckworth, MD, assistant professor, neurological surgery, Loyola University Chicago Stritch School of Medicine. “This reduces the risk of the tumor coming back.”
Loyola’s skull base/neurological surgery team features neurosurgeons and ENT (ears, nose and throat) surgeons working together in the operating room. In some cases, they use a catheter and an image-guidance system, similar to a GPS system that many consumers are familiar with, to see inside tiny blood vessels in the brain in ways not possible before.
Loyola neurosurgeons and ENT surgeons often collaborate during minimally invasive surgeries. The multi-disciplinary surgical team helped save Wayne Bagwill’s eyesight.
“My doctors said a pituitary tumor was pushing on my optic nerve, and if I didn’t get it removed, I would probably go blind,” remembered Wayne, a 69-year-old retiree, husband of 47 years and father of four adult children. They also said that for this surgery, Loyola was the place, so that’s where I went.”
Dr. Zender “constructed the highway” that allowed Dr. Duckworth to remove Wayne’s tumor. Both physicians said research shows that endoscopes not only provide better views of the tumor, but the lack of large and prominent scars helps patients recover emotionally and psychologically after surgery.
Would Wayne recommend this type of procedure to others? “Oh, definitely. I can see as well as I could before, and I had very little pain afterwards. I took over-the-counter painkillers a couple of times in the hospital, and I haven’t taken any pills since I left. I was very pleased with the care at Loyola. Everyone there is great.”
Wayne also knows what might have been his fate had his doctors not encouraged him to go to Loyola. “A friend’s daughter-in-law had the same problem, and her doctors went in through her skull. Now she has scars on her forehead, but I have no scars at all. And her recovery process was much longer than mine.”
Drs. Duckworth and Zender apply their expertise to a variety of patients, some of whom had avoided potentially life-saving therapy before they learned about the minimally invasive techniques.
“There are people who are more afraid of brain surgery than they are of leaving an aneurysm untreated,” explained Dr. Duckworth. “Others live with epileptic seizures because they think brain surgery is dangerous and that they’ll have to get their head shaved. If people understood that we’re treading lightly to take care of them, and we’re reducing their time in the hospital and the cosmetic implications, more patients would receive effective treatment.”
For more information on Loyola’s expertise in neurological and otolaryngological surgery, or to schedule an appointment, please call (888) LUHS-888.
LOYOLA UNIVERSITY HEALTH SYSTEM
