Southampton surgeons offer brain surgery through nose

Leading surgeons based at Southampton’s university hospitals are carrying out cutting edge brain surgery through the nose.

The innovative technique, which is at the forefront of neurosurgery across the world, is used to remove skull base tumours and is performed entirely by entering the skull through the nose, known as endonasal endoscopic skull base surgery.

Consultant skull base neurosurgeon Nijaguna Mathad and ENT surgeon Salil Nair have pioneered the procedure at Southampton General Hospital’s Wessex Neurological Centre.

Using the surgery has enabled them to reach tumours at the base of the skull and at the top of the spine directly using an endoscope that transmits images onto a high definition TV screen in the operating theatre.

Previously, neurosurgeons would have had to perform the operation by splitting the facial skeleton or peeling back scalp and removing the skull on the forehead.

“This minimal access and maximal invasive procedure is at the cutting edge of neurosurgery,” Mr Mathad said.

“One of the first patients we used this technique on was suffering from a tumour with an erosion of the skull base.

“Conventionally, he would have undergone a bifrontal craniotomy with its associated risks of epilepsy and stroke. It would also have required the patient to remain in hospital for a number of days and restricted them from driving afterwards.

“By using the endonasal endoscopic procedure, we were able to reach the tumour with minor disturbance to the surrounding parts of the brain and did not need to make incisions on the head, which would have resulted in a longer hospital stay.”

Mr Mathad added: “The patient made an uneventful recovery and was discharged from hospital within 48 hours, which was a truly short stay for such a major procedure.”

Mr Mathad and Mr Nair are also offering endoscopic trans-sphenoidal pituitary operation as part of their wider endoscopic skull base surgery.

Posted on Wednesday 28 October 2009