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New Less-Invasive Surgery Removes Tumors Through Natural Skull Opening

A new scarless surgical technique that involves entering the body above the jawbone though a natural opening has proven successful in removing tumors at the base of the skull.

This new technique developed by surgeons at Johns Hopkins University School of Medicine involves entering the body above the jawbone, behind the molars and beneath the cheekbone, which means there are no visible scars. The surgery, which has been performed successfully in seven patients, also yields fewer complications and faster recovery.

Traditional surgeries to remove skull base tumors require incisions through the face and bone removal, which can sometimes be disfiguring. Additionally, these operations can harm facial nerves, leading to paralysis that affects facial expressions and days or weeks of hospitalization and recovery.

The idea for the new approach was inspired by a 20-year-old female patient previously treated for a brain tumor who developed a new tumor deep in the skull base, according to Dr. Kofi Boahene, an assistant professor of facial plastic and reconstructive surgery and otolaryngology at the Johns Hopkins University School of Medicine.

Examining a skull model in his office, Boahene said he was considering options to spare his patient from another traditional surgery.

“I looked at the ‘window” that already exists in the skull, above the jawbone and below the cheekbone and realized this was an access route not previously recognized for this kind of surgery,” he said.

Boahene and his colleagues performed the new procedure on his patient last year, knowing they still had the option of switching to the traditional approach. The expected surgery time went from six hours to two. The patient also was able to leave the hospital after one day and return to college, with no visible scars from the surgery.

The report in The Laryngoscope describes details of the surgeries on three of the seven patients Boahene and his colleagues have thus far treated.

In addition to the benefits for patients, Boahene and his colleagues say the new procedure is a lot less complicated for surgeons to perform, provides outstanding visualization of the skull base area, and could also save health care dollars due to patients’ shorter hospital stays.

Unfortunately this procedure is not for everyone, researchers say. It isn’t an option for those with very large skull base tumors or those with tumors that wrap around blood vessels. Traditional skull base surgery is still the best choice for those patients.

Looking ahead, researchers plan to try the new procedure using a surgical robot, which could provide better visualization for surgeons and also reduce even more the chances of complications for patients.

For more on medical safety issues, see the library of articles by Daytona Beach medical malpractice attorney.

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