Neurology Otolaryngology News Archive Featured in the Media JeffNEWS

A state of the art program has opened at Thomas Jefferson University Hospital offering a new alternative for people with brain and skull base tumors. The Jefferson Center for Minimally Invasive Cranial Base Surgery and Endoscopic Neurosurgery is a comprehensive center in the Philadelphia area where surgeons are able to remove skull-based tumors through nose and nasal sinuses instead of the traditional, more invasive surgery which required opening up the brain and skull.

Marc Rosen, M.D., assistant professor of Otolaryngology-Head and Neck Surgery, and James Evans, M.D., assistant professor of Neurosurgery, both of Jefferson Medical College of Thomas Jefferson University serve as the center’s co-directors. Drs. Evans and Rosen have been working together for several years and have performed at least 150 of these endoscopic procedures to date.

“This leading edge surgical technique gives us a new way to treat patients with benign and malignant brain, cranial base and sino-nasal tumors,” noted Dr. Rosen.

“Through this Center, our multidisciplinary team of medical experts has been able to dramatically improve patient outcomes and reduce the length of hospital stays,” added Dr. Evans. “Patients can also begin radiation and chemotherapy sooner than they would be able to with conventional surgical procedures.”

“Jefferson’s innovative program combines neuro-navigation, endoscopic technology and minimally invasive approaches to effectively treat many cranial base and intracranial tumors previously requiring lengthy and often destructive procedures,” said Dr. Evans.

“Better visualization and access to these difficult lesions has enabled improved resection, preservation of function, decreased post-operative morbidity, decreased hospital stay and fewer complications,” added Dr. Rosen

The new center at Jefferson has minimally-invasive operating suites in which to perform these procedures, equipped with state of the art computer navigation systems, and new endoscopic instrumentation. These procedures are also complimented by the Department of Neurosurgery’s Division of Neuro-Oncologic Neurosurgery and Stereotactic Radiosurgery. The Jefferson Hospital for Neuroscience is equipped with both a Novalis® Shaped Beam radiosurgery unit and gamma knife radiosurgery unit, representing the first configuration of its kind in the Delaware Valley. Our team is involved in advancing the field in skull base reconstruction surgical techniques and the development of state of the art robotic surgery technology.

Traditionally, cranial base tumors have been removed by opening large holes in a patient’s skull and by removing facial bones.

Jefferson’s multi-disciplinary team instead applies a more high-tech, minimally-invasive approach which is less destructive. The surgeons first use a thin endoscope with a camera attached to enter a patient’s nose and sinuses, allowing them to approach the tumors without external incisions.

Guided by the scope and enhanced computer navigation, the surgeons open small holes in the base of the skull and membrane covering the brain. The tumors are removed either in one piece, or broken up into smaller pieces if the tumors are too large.

“This is a radical departure from conventional surgery and is the newest extension of minimally-invasive surgery,” Dr. Rosen noted.

“This is sure to be the standard of care in the near future,” added Dr. Evans.

Some examples of the many conditions that can be effectively managed by minimally invasive endocsopic techniques include: pituitary tumors, craniopharyngiomas, chordomas, chondrosarcomas, meningiomas, sino-nasal malignancies, juvenile nasal angiofibroma, cerebrospinal fluid leaks, meningoceles, encephaloceles, colloid cysts, as well as other intracranial and intraventricular tumors.

For more information about Jefferson’s new Center for Minimally Invasive Cranial Base Surgery and Endoscopic Neurosurgery, or to make an appointment with a Jefferson physician, call 1-800-JEFF-NOW.