USA During brain tumor removal surgery, a 30-year-old male patient played the guitar so that doctors could assess his hand motor function.
The surgery took place at the Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine. Christian Nolen, an avid guitarist, had a tumor in his right frontal lobe and began to experience characteristic symptoms. According to Ricardo Komotar, director of the center’s brain tumor program, he had problems with the left side of his body, especially his left hand. The tumor affected Nolan’s dexterity and ability to play the guitar.
He was scheduled for surgery to diagnose, determine the type of tumor, and remove it if necessary, as each tumor has different treatment options. The surgery was scheduled for 10 days after the tumor was discovered. Nolen was surprised when the doctor asked him if he would be willing to play guitar during the surgery.
“When a tumor is invasive or near a critical part of the brain, such as the part that controls speech, language comprehension, or movement, we often want to operate while awake so we can continue to monitor the patient. This helps the surgeon know whether he or she is hitting parts that are functioning normally,” explains Dr. Komotar.
When the patient is in a deep sleep, the surgical team cannot receive the necessary feedback. The surgery becomes much more dangerous at this point, because the surgeon can remove a part related to brain function, causing damage to the patient's body.
Because the guitar was such an important part of Nolen's life, Dr. Komotar asked him to play it to monitor his dexterity.
“I had only heard about this in movies and TV shows. For me, this experience was unique and not to be missed, especially as my motor skills were developing,” he shared.
Before the surgery, the entire team met with the patient and went over what to expect. Initially, doctors put Nolen under anesthesia for the craniotomy. He was awakened for the next two hours. After Nolen got his bearings, the team handed him a guitar.
"When I woke up, I felt overwhelmed looking at everything around me, having to fight the natural urge to sit up," he recounted.
Christian Nolen plays guitar during brain surgery at Sylvester Comprehensive Cancer Center. Photo: Sylvester Comprehensive Cancer Center
Once he calmed down, he played songs he had learned by Deftones and System of a Down. Doctors removed the tumor and continuously monitored Nolen's hand function.
Nolen's dexterity was impaired when the surgeon worked behind the tumor, which meant the tumor was touching the part of his brain that controls hand movement. Still, the surgical team successfully removed the tumor without damaging the nerves in his hand.
“This is crazy,” Nolen exclaimed during surgery.
Keeping patients awake during brain surgery is not uncommon, but it is common practice among surgeons. Dr. Komotar said he and his colleagues do it several times a week, a total of several hundred times a year.
"The less anesthesia used during surgery, the more awake the patient is. The faster they wake up, the easier their recovery becomes. In fact, a long hospital stay can lead to many complications," he said.
The biggest risk of performing an awake brain tumor resection is that the patient “cannot stand” being woken up (about 5% to 10%). Even with careful anesthesia, they sometimes become startled or in too much pain, confused, agitated, or do not follow the doctor’s instructions. If this happens, the surgical team will put the patient back to sleep and remove the tumor more carefully.
Nolen was able to return home the day after surgery. He said his quality of life has never been better. He struggled in the first few weeks, mainly due to post-operative restrictions.
He is awaiting final pathology results and is preparing for six weeks of chemotherapy and radiation. Both Komotar and Nolen stressed that the success of the surgery depends on the cooperation of the entire care team.
Thuc Linh (According to Fox News, NME )
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